Biosimilar Transition Effective July 1, 2026

Our pharmacy benefit manager, Med-Impact, is implementing a formulary update effective July 1, 2026, as part of a broader strategy to manage prescription drug costs while maintaining access to effective therapies. This update reflects the continued shift toward biosimilar medications, which offer the same clinical benefit as brand-name drugs at a lower cost.

What’s Changing?

Beginning July 1, 2026, Humira (adalimumab), adalimumab-adaz, & Simlandi  will be removed from the formulary and designated as non-formulary. This means they will not be covered under the prescription drug plan after this date.

The preferred alternative will be adalimumab-ryvk, an interchangeable biosimilar. Because it is interchangeable, pharmacies may be able to substitute it for Humira or Simlandi without requiring a new prescription, depending on state regulations and pharmacy practices.

Important Coverage Information

It’s important to understand how this change works with your prescription benefits:

• Non-formulary medications are not covered under the plan
• Humira, adalimumab-adaz, & Simlandi will be non-formulary as of July 1, 2026 and will no longer be covered
• Cost-sharing provisions—such as paying a higher coinsurance for brand-name drugs—only apply to medications that are on the formulary
• If a medication is not on the formulary, it is not eligible for coverage, regardless of brand or generic status

Member Communication

Med-Impact will mail a letter to impacted members who have filled a prescription for Humira, adalimumab-adaz, or Simlandi within the past 120 days. The letter will explain the change, outline the preferred alternative, and provide guidance on next steps.

What Should Members Do?

If you are currently taking Humira, adalimumab-adaz, or Simlandi:

• Be aware that coverage will end after June 30, 2026
• Watch for the mailed communication from Med-Impact
• Talk with your healthcare provider about whether switching to adalimumab-ryvk  is appropriate for you

If you have questions, please contact the number on your pharmacy benefit ID card for assistance.