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Health New England to replace Humira coverage with lower-cost biosimilars
SPRINGFIELD, Mass. (WWLP) – Health New England announced Monday that it will shift coverage of the biologic drug Humira to more affordable FDA-approved biosimilars starting next month for members of its commercial health plans.
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Effective July 1, the not-for-profit health insurer will cover Amjevita by Nuvaila and Hadlima instead of Humira, as part of a broader effort to manage rising health care costs while maintaining access to effective treatments.
Humira is used to treat several chronic inflammatory conditions, including rheumatoid arthritis, Crohn's disease, and plaque psoriasis.
'Biologic medications like Humira are complex treatments that carry significant cost. Its biosimilars provide a meaningful opportunity to enhance affordability for the health care ecosystem while members continue to get the full benefits of the medication,' said Gary Tereso, PharmD, Director of Pharmacy Services at Health New England.
Biologic drugs are made from living organisms and are typically more expensive than other medications. Biosimilars are developed to be nearly identical in safety, potency, and efficacy to the original biologic, but at a significantly lower cost. The shift in coverage is intended to make treatment more accessible and financially sustainable for members and employer groups alike.
Health New England is directly reaching out to members who are currently prescribed Humira, along with their health care providers and pharmacies, to assist with the transition. The company said it will continue monitoring the biosimilar marketplace to ensure members receive both high-quality care and cost-effective treatment options.
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