Iceland's Prescription for the Future of Medicine

Biologic medicines have transformed healthcare by providing targeted treatments for chronic and life-threatening diseases. But their eye-watering price tags—sometimes over USD 100,000 per patient per year—place them out of reach for millions worldwide. Needless to say, the personal and societal consequences can be devastating.

Alvotech, a biopharmaceutical company based in Reykjavík, is working to change that. The company specializes in biosimilars, which are near-identical versions of existing biologic drugs. These biosimilars must offer the same safety, efficacy, and quality as the originals, but at a significantly lower cost. By virtue of lower pricing, Alvotech helps expand access to advanced care in both developed and emerging healthcare systems.

Unlike conventional pills or capsules, biologics are large, complex molecules produced in living systems. They require specialized laboratories, advanced analytics, and highly regulated processes. In the United States, specialty medicines, including biologics, are used by fewer than 2 percent of the population, yet they account for 51 percent of total pharmacy spending.* This imbalance places a heavy burden on healthcare systems and limits access to treatment for many patients.

To clarify, biosimilars are not equivalent to “generic drugs.” Biosimilars must be proven to be highly similar to their reference products, with no clinically meaningful differences in safety, purity, or potency. Furthermore, biosimilars offer a more sustainable solution by delivering the same therapeutic benefit at a fraction of the cost.

Because biosimilars are still very complex, they have traditionally been expensive to develop, test, and manufacture. Alvotech is rewriting that script with a model that is designed for scale, speed, and sustainability.

Alvotech is one of the few biosimilar companies worldwide with an in-house, end-to-end process. From early cell line development to clinical trials and commercial manufacturing, everything happens under one roof in Reykjavík. More than 85% of the company’s 1,000+ employees are dedicated to R&D and manufacturing, a system that enables faster and more efficient delivery of treatments.

Alvotech currently has eight biosimilars in its portfolio and development pipeline. These include alternatives to some of the most widely used biologics worldwide, with applications in autoimmune diseases, oncology, and ophthalmology. Among them are biosimilars to Humira® and Stelara®, used to treat conditions like rheumatoid arthritis and Crohn’s disease; Eylea®, prescribed for macular degeneration and diabetic eye disease; and KEYTRUDA®, one of the leading immunotherapies for cancer. Each biosimilar is designed to expand access to proven treatments that remain out of reach for many patients due to cost. In lower-income countries, biosimilars may represent the only realistic way to expand access to modern biologic medicine.

The company’s medicines are already reaching patients in over 90 countries, including the U.S., Europe, and Asia, through strategic partnerships with leading healthcare providers. As more countries expand biosimilar approvals, Alvotech is well-positioned to accelerate access to proven therapies on a global scale and expand capacity to meet the future needs, while ensuring its facilities meet the exacting cGMP standards of the Food and Drug Administration (FDA) and European Medicines Agency (EMA).

Alvotech’s vertically integrated approach is powered by Iceland’s abundant clean energy and fresh water. Alvotech’s facilities operate on renewable hydro and geothermal energy, significantly reducing emissions in a traditionally resource-intensive industry. Iceland’s renewable energy grid and abundant water resources give Alvotech a strategic advantage as it scales production responsibly. The company also utilizes single-use bioprocessing systems, which conserve water, minimize the need for harsh cleaning chemicals, and enable faster product changeovers, a necessity for global responsiveness.

As healthcare systems face increasing pressure and widening treatment gaps, Alvotech offers a model of what’s possible when biotech innovation meets a mission of equity and sustainability. Biosimilars offer a more sustainable path forward by reducing the cost of care without sacrificing quality. As a consequence, biosimilars help free up resources for next-generation therapies while delivering real-world benefits today.
If more countries followed Iceland’s lead on biosimilars, could global healthcare become more equitable?

* Source: Evernorth, “Specialty Drug Trends and Utilization”