Pharmacy Update: Humira Biosimilars Strategy for Lowest Net Cost Formulary Effective Jan. 1, 2025

The changes in this update apply to all groups that use OptumRx

Beginning Jan. 1, 2025, Humira (brand) will be removed from the Lowest Net Cost formulary. Adalimumab biosimilars will instead be the preferred products for this formulary.

This new biosimilar strategy provides continued quality of care for patients, guaranteed supply, availability of high-concentration doses, and affordability for patients, including manufacturer copay assistance programs and significant cost reduction for plan sponsors.

Preferred Adalimumab Biosimilars effective 1/1/2025

Lowest Net Cost 

Amjevita by Nuvaila*#
20mg/0.2mL
40mg/0.4mL
80mg/0.8mL

Hadlima*
40mg/0.8mL

*Low list price option
# Optum Rx has contracted with Amgen to private label the Amjevita/adalimumab product as Nuvaila

Member Experience

• Letters will be mailed to members impacted by this change.
• Members should work with their providers to ensure a new prescription is sent to their pharmacy.
• Specialty pharmacies can assist members with enrolling in manufacturer assistance programs.
• Humira biosimilars are designed to be biologically similar to the reference medication and are just as safe and effective.

Provider Outreach and Action Needed

• Providers will be notified of this formulary change prior to implementation. 
• Providers should send new prescriptions for one of the preferred biosimilar products to a network Specialty Pharmacy.