Humira to be Replaced by Biosimilars on April 1

Effective April 1, 2024, Humira is being replaced on the NRECA Medical Plan’s prescription drug list by two biosimilars, Adalimumab-adaz and Hyrimoz. Humira is used to treat inflammatory conditions such as rheumatoid and psoriatic arthritis and autoimmune diseases like Crohn’s disease and ulcerative colitis. CVS mailed letters at the beginning of February to the 221 plan participants currently using Humira.

As shown in the sample letter, the formulary changes are outlined by each of the 11 conditions Humira is approved to treat. There are multiple new biosimilars for Humira, the most notable being Stelara, which is projected to be FDA-approved in 2025 for use in treating Crohn’s disease.

What is a biosimilar?
As the term suggests, biosimilars are highly similar to their brand name specialty drugs with comparable quality in bringing the same treatments to people dealing with conditions like cancer and other chronic illnesses. Cost savings with biosimilars vary but can be significant depending on the drug and the number of competitors in the market.

Biosimilars are added to a plan’s prescription drug formulary drug list, replacing certain brand name specialty drugs, as their approval by the Food and Drug Administration (FDA) and availability expands. Since 2015, 45 biosimilars have been approved by the FDA. Of these, 37 biosimilars are currently on the market for prescription drugs such as Remicade, Enbrel, Humira and insulin.

Questions If you or your affected participants have questions about these updates or other questions about prescription drug coverage, call CVS Caremark Customer Care at 888.796.7322.