Extra Medicare plans cowl Humira biosimilars, however use is not inspired
Medicare drug plans considerably boosted protection of biosimilar variations of the Humira rheumatoid arthritis medication this yr, however practically all of them did not take steps that will encourage better use of those different therapies, a brand new authorities watchdog report finds.
The report discovered that 96% of the Half D plans and 88% of the Medicare Benefit drug plans agreed to cowl no less than one of many 10 out there copycat medicine on their 2025 formularies. And a few didn’t cowl the brand-name model. This was an enormous bounce in protection from 2024, when solely 64% of the Half D plans and 52% of the Medicare Benefit drug plans lined no less than one biosimilar model of Humira.
General, 99% of enrollees in Half D Plans and 90% in Medicare Benefit drug plans had entry to no less than one Humira biosimilar in 2025. Nonetheless, some plans are nonetheless limiting entry to the biosimilars this yr, which precludes utilization. Particularly, 10% of Medicare Benefit drug plans and 1% of Half D plans cowl solely the brand-name remedy.
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