MedImpact Broadens Access to Two Humira Biosimilars for New Patients

MedImpact Healthcare Systems, Inc., the largest independent provider of health solutions, technology, and pharmacy benefit services in the United States, has announced an expansion in their pharmacy benefit plan. This expansion includes increased access to Humira biosimilars, specifically Simlandi and adalimumab-adaz, for new patients needing treatment for inflammatory diseases like Crohn’s disease or rheumatoid arthritis. Existing patients who are currently prescribed Humira can continue their regimen without any changes. Moreover, if new patients have previously tried one of these biosimilars but did not achieve the desired therapeutic results, they are permitted to switch to Humira.

Nicole Ellermeier, PharmD, MBA, who serves as Vice President of Formulary Strategy & Rebate Economics at MedImpact, stated that the decision to include these biosimilars in the pharmacy benefit plan stems from their confidence that these biosimilars meet rigorous standards for clinical interchangeability and cost-effectiveness. Ellermeier emphasized that the strategy aims to provide flexibility and choices for members, providers, and payers, thereby instilling confidence in the treatment options available.

MedImpact has a longstanding tradition, spanning 35 years, of maintaining neutrality regarding pharmacy and manufacturer choices. The newly announced approach aligns with this tradition by allowing members to have their prescriptions for FDA-approved biosimilars filled at any pharmacy, irrespective of the manufacturer. This level of flexibility is not commonly available in the current marketplace. Recognizing the intricate nature of biosimilar manufacturing and potential supply chain issues, MedImpact has made two biosimilars available to ensure consistent availability.

To prioritize clinical considerations over cost, MedImpact has structured member copays, deductibles, and other relevant out-of-pocket expenses to be the same for both the biosimilars and Humira. This ensures that members have the flexibility to choose their treatment without facing additional financial burdens.

MedImpact is committed to continuously monitoring the biosimilar market and plans to introduce additional biosimilars to its formularies as they meet the necessary clinical, supply chain, and cost criteria.

Arpit Patel, PharmD, Vice President of Trade Relations at MedImpact, noted that expanding access to biosimilars involves complex clinical and economic factors. However, MedImpact’s guiding principle remains clear: they aim to provide convenient and affordable access to clinically appropriate medications while ensuring financial sustainability for both patients and payers.

MedImpact Healthcare Systems, Inc., headquartered in San Diego, has been serving as a key player in the health solutions, technology, and pharmacy benefit management sector for 35 years. The company has a track record of assisting both commercial and government healthcare payers in improving member health, managing benefits, and reducing drug costs.