Humira Biosimilars Update

We have recently updated our Humira/biosimilar coverage for members with PAI’s pharmacy benefit coverage with OptumRx that use the Lowest Net Cost (LNC) Formulary.  Make sure to check your benefit plan for eligibility. Strategies through the remainder of 2024 will include:

o    Humira [manufacturer: Abbvie]
o    Adalimumab-adaz [manufacturer: Sandoz] 
o    Hadlima [manufacturer: Organon] 
o    Adalimumab-adbm [manufacturer: Boehringer Ingelheim]

What are Humira biosimilars?

Biosimilars have been gaining significant prominence in the pharmaceutical landscape. Since our last bulletin, 4 additional biosimilars have been launched to the marketplace, gaining rapid attention and use. They continue to have comparable safety and efficacy profiles while offering more cost-effective alternatives. There are currently 11 biosimilars to Humira, with more in current development.

Biosimilars are not generics but are close replicas of the original biologic, which is a complex protein made using living cells. Humira biosimilars have been increasingly approved and marketed in the United States.

What are the takeaways?

As Humira biosimilars gain momentum in the market, they present valuable treatment options for members with chronic inflammatory conditions. We encourage healthcare providers to consider the use of Humira biosimilars when appropriate. The market for Humira biosimilars continues to evolve; staying informed about these medications is crucial to make well-informed decisions regarding patient care and formulary management.

Please reference original Humira Biosimilars Update Bulletin dated August 3, 2023 for previous communication.