We've made a change to our formulary lists. We have replaced Humira with biosimilars. Biosimilars don’t have any clinical differences in effectiveness. These medications cost less than Humira, which can help you save while treating the following:
- Rheumatoid arthritis
- Crohn’s disease
- Other autoimmune diseases
You can find out how much you can save online. You can click on the “Cost & Savings” link within the prescription tab on the Member Portal.
The preferred biosimilars are:
- Adalimumab-aaty (unbranded Yuflyma)
- Adalimumab-adaz (unbranded Hyrimoz)
- Hadlima
- Simlandi
What this means for members
If you have a prescription for Humira you will get a letter before the change takes effect.
You won’t need a new prior authorization (PA) for a biosimilar. New PAs for biosimilars were proactively entered by Prime Therapeutics on Jan. 1, 2025. The new PA will be in effect through the date of the original Humira PA.
There are options if you think Humira is medically necessary. You or your provider can submit a PA for review.
Keeping pharmacies up to date
Pharmacies will be notified about the change in formulary coverage of Humira. The notification will explain safety and effectiveness of these biosimilars.
If you have any questions, please call Member Services: 844-363-8457.
