Humira has been the world’s best selling medicine since it arrived on the market in 2002. Now, it is finally getting competition with the release of Amgen’s biosimilar drug, Amjevita. Humira’s main patent on Humira expired in 2016, but a byzantine patent saga has kept other drug makers from offering their own version of the monoclonal antibody used to treat conditions such as rheumatoid arthritis and crohn’s disease.

In this video, STAT senior writer Ed Silverman breaks down the convoluted world of pharmacy benefit managers, formularies, and a legal maneuver called “patent thicketing” that controls how much patients pay for this beneficial treatment.

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