As part of its commitment to supporting member choice and promoting greater affordability, CarelonRx will add Humira biosimilars on December 1. Adalimumab-adbm (lower list price version) will be added to all CarelonRx commercial formularies. Cyltezo will be added to select commercial formularies. Both will be at parity with Humira.

These biosimilar alternatives to Humira, the number one selling drug in the US for more than a decade, will drive expanded treatment choices for members living with inflammatory conditions and increased cost management opportunities for plan sponsors.


Advancing access, options, and affordability

Inflammatory conditions and the vital specialty drugs used to treat them have accounted for an ever-growing share of drug spend, and the biologic drug Humira, highly utilized to treat conditions such as rheumatoid arthritis and Crohn’s disease, has topped CarelonRx’s list of drugs by spend for several years.

Access to Humira biosimilars offers more options for members with chronic and complex conditions, and it delivers greater potential for improved affordability and plan savings, as well. When considering a biosimilar for our formularies, we want to ensure access to clinically equivalent treatment while expanding choice for members.


The selection of Cyltezo and adalimumab-adbm

Our critical focus on clinical quality, competitive pricing, patient assistance programs, and interchangeability to help drive member adoption, led CarelonRx to select adalimumab-adbm and Cyltezo, which are produced by Boehringer Ingelheim.

Both Cyltezo and adalimumab-adbm are the first biosimilars to receive an interchangeable designation by the FDA. (An interchangeable biosimilar product meets additional requirements that make the drug suitable to be substituted without consulting the health care provider, where applicable.)

By keeping Humira on our commercial formularies, while adding these biosimilars at parity with Humira, we deliver more choice to our members and providers. And by continuing to monitor the pipeline, CarelonRx can support biosimilar adoption while driving competition and increasing access to cost-effective new treatments.

We expect additional biosimilars to be FDA-approved and available in 2024. We will continue to respond with strategies that promote clinically appropriate care first and foremost, while hedging against considerable cost drivers in historically expensive specialty drug classes.

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