Biosimilars present a significant opportunity to enhance access to affordable medications for our community. Since 2018, Univera Healthcare has been a strong advocate for biosimilars, beginning with the inclusion of our first biosimilar on our covered medication list. Today, we offer biosimilars across all 10 drug categories where they are available.
Humira™ (adalimumab) is the top-selling pharmaceutical in the world, indicated for many autoimmune, rheumatologic, and gastrointestinal diseases. The first Humira biosimilar launched in 2023. Now, 18 Humira biosimilars are approved in the US.
Univera Healthcare offers multiple formulary options for our large employer groups, dependent on the funding arrangement. In 2024, Univera Healthcare commercial formularies preferred the biosimilars Cyltezo® and Hadlima along with the reference drug Humira.
For 2025:
- The low wholesale acquisition cost (WAC) biosimilar Simlandi® has been added as a preferred biosimilar. Simlandi is an interchangeable biosimilar which means pharmacies can dispense Simlandi instead of Humira without prior physician approval.
- Hadlima will remain preferred, it is available in both high and low concentrations and has a low wholesale acquisition cost.
- Humira will remain preferred.
- Cylesto will no longer be preferred.
Due to the natural transition to the interchangeable biosimilar Simlandi and competitive pricing for Humira, Univera Healthcare believes that keeping Humira on our formularies ensures stability for members. This is another way we continue to support the Western New York Community.
This strategy applies to 3 Tier Open, Preferred Value Formulary and Exchange Closed Formulary. All three drugs Humira, Hadlima, and Simlandi will be Tier 2 in 2025.
Through our partnership Express Scripts (ESI), we also offer the National Preferred Formulary (NPF) to our self-funded employer groups:
- Effective January 1, 2025, Humira will be excluded for new members.
- Effective July 1, 2025, Humira will be excluded for all members.
- The NPF has both high and low WAC biosimilars as preferred. They include Adalimumab-adaz by Sandoz, Adalimumab-adbm by Quallent, Adalimumab-ryvk by Quallent, Cyltezo, and Simlandi.
No matter which formulary our clients choose, they will continue to benefit from the cost savings driven by increased competition from biosimilars.
Biosimilars are safe, effective, and Food and Drug Administration (FDA) approved medications. By adding them to our covered medications, we give members options and help expand access to affordable treatments in our community.
To learn more about biosimilars see Understanding the Biosimilar Landscape on UniveraForBusiness.com.
