Blue Cross & Blue Shield of Kansas Creating Innovative Solutions to Lower Medication Costs

New biosimilars for Humira being added to prescription formulary

With a commitment to affordability, Blue Cross and Blue Shield of Kansas (BCBSKS) has added two biosimilar medications for Humira™ (adalimumab) to its list of covered medications for people living with inflammatory conditions such as rheumatoid arthritis, psoriatic arthritis, and more.

“We take several factors into account when determining what we add to our prescription formulary including the safety, effectiveness and cost of the medication,” said Tiffany Liesmann, BCBSKS chief pharmacist. “The rising costs of prescription medications are a large part of today’s healthcare crisis, but biosimilars have the potential to save the U.S. healthcare system up to $375 billion in total pharmacy spending over the next decade.”

Humira is the top selling drug of all time and until recently, had little competition. Since its introduction, Humira’s list price has increased by 470%. While there will be no changes in coverage of Humira™ products, coverage of Amjevita™ (NDC’s beginning with 55513) and Hadlima™ will provide members with clinically effective, cost-efficient means to treat their inflammatory conditions.

There are no clinically meaningful differences between Humira and the biosimilar adalimumab products, so patients are not expected to experience a change in the safety or effectiveness of their treatment if members utilize covered adalimumab biosimilars.

What is a biosimilar?

A biosimilar is a biologic (medicines generally derived from living organisms) that is highly similar to, and has no clinically meaningful differences from, another biologic that has already been approved by the Food and Drug Administration. Biosimilar medications typically cost less and show no clinically meaningful difference from the originator medications. Biosimilars are to biologics what generics are to brand-name medications.

Always consult with your doctor to determine what medications are best for you. Members with specific questions about their coverage should contact BCBSKS Customer Service Center toll-free at 1-800-432-3990.