Additionally, the Underwater Biosimilars Coalition, spearheaded by the ACR and the Coalition of State Rheumatology Organizations, continues its work to address these issues with agencies and Congress.
UHC Pharmacy Drug List Changes
The ISC has engaged in dialogue with UnitedHealthcare as the payer formalizes changes to its pharmacy drug list for 2025. One key coverage change to note is that UHC-preferred adalimumab products will include bio-originator adalimumab (Humira) in addition to biosimilars adalimumab-atto (Amgevita) and the unbranded version of adalimumab-adaz. In the IL-17 category, secukinumab (Cosentyx) will remain preferred; however, it will move from tier 3 to tier 2 and the current requirement to step through two other products will be eliminated.
Commercial plans routinely announce policy and formulary changes in October and November for the following year. The ISC is available to help members navigate these changes and advocate for your practice and patients. For more information about the issues above or to request ACR’s help on other specific payer issues affecting your practice, ACR/ARP members can reach out to [email protected].