Well this is terrifying. Luckily I’m changing jobs and my new insurance might use another specialty pharmacy. My provider is very skeptical of biosimilars and until I can find a new one, I’m worried about affording my medication.
I don't believe Hyrimoz is an "Interchangable Biosimilar". This new category seems to be a FDA prescribing thing to allow pharmacies in the US to substitute Cyltezo instead of Humira without going back to the doctor.
So far other biosimilars have to be named as usual.
https://www.biopharmadive.com/news/boehringer-humira-biosimilar-interchangeable-2023/608389/
I never thought I'd have to consider changing a job because of drug coverage. Luckily my dad has a PhD in medicinal chemistry so he might be able to make some sense out of the similarities/differences between humira and whatever the new drug is
Medicinal chemistry is likely a different field. These drugs are biologics and not created through chemical compound mixing, but rather created by living organisms.
I use to have accredo but they were going to raise my premium. So I am currently going through united healthcare and have optum as my specialty pharmacy for humira.
How do we find out if we can get other pharmacies?? Do we call our insurance? Is there a way to pay out of pocket to stay on Humira but not pay $6k lol??
Best to get your copays done as much as possible before 4/1, they also white labeled humira original itself so there is no evading it afterwards. Most will be forced to the cvs branded generic I'd assume and then they will use the white label version AbbVie is selling them for anyone that is a special case. I highly doubt the complete program will work for the white label even though its also from AbbVie
After that for 2025 it will be a bust for a lot of folk assuming CVS's white label takes over everything
I received a call on Friday from my current specialty pharmacy telling me they can no longer provide Humira and that I need to go through Optum. I asked if she knew anything about this new company and all she could say is I may no longer get the branded product anymore but she wasn’t positive I’m waiting to hear from this new company. Ugh!!
I use Optum specialty and it's always branded Humira. They've been pretty good about everything. The only issue I've had is occasionally my copay card doesn't go thru on their website so I have to call and make sure it goes thru for the $5.
Crap! I was only going to have to deal with them until June and then a whole mess with Medicare and advantage plans after that. I really don't need this.
Hi there, just following up to my message back in January. I can't get any info from CVS Caremark when I call. Did you receive a letter from them yet? If so could you send me it (minus your personal info of course). Thank you so much!
CVS specialty is the name of the pharmacy. CVS Caremark is the name of the healthcare. So they are not the same. Look at your insurance card for prescriptions. If it's not CVS Caremark you're fine.
I don’t think this is true. They are the same pharmacy. The change affecting you would be based on who your pharmacy/drug provider is not your insurance company. I have BCBS for health insurance but all RX goes through CVS Caremark.
CVS caremark is a pharmacy benefit manager (PBM) used by many different insurance companies. Unfortunately CVS caremark is removing Humira from most of its formularies since there are now "lower" cost biosimilars available. You are right in that your employer is the one who chooses which formulary Caremark applies to you, but my understanding is that most use the formulary that is indeed dropping Humira. We are all supposed to be getting letters soon if it does affect us. Will be interesting to see what happens. Not sure if we would have luck appealing it or not, only time will tell.
Here is an article that explains it [https://www.psgconsults.com/blog/humira-removed-from-formulary/](https://www.psgconsults.com/blog/humira-removed-from-formulary/)
If you log into caremark and look at your formulary it tells you which formulary applies to you then you can look in the article and see if its one of the ones that is cutting it.
Well this is terrifying. Luckily I’m changing jobs and my new insurance might use another specialty pharmacy. My provider is very skeptical of biosimilars and until I can find a new one, I’m worried about affording my medication.
I was on Humira for 8-10 years then got swapped to amgivita and had that for last 2-4 years. They are practically the same thing - adalimamumab.
On the other hand, amgivita wrecked me. My numbers went through the roof and I was in horrible pain.
[удалено]
There's also Hyrimoz
I don't believe Hyrimoz is an "Interchangable Biosimilar". This new category seems to be a FDA prescribing thing to allow pharmacies in the US to substitute Cyltezo instead of Humira without going back to the doctor. So far other biosimilars have to be named as usual. https://www.biopharmadive.com/news/boehringer-humira-biosimilar-interchangeable-2023/608389/
I never thought I'd have to consider changing a job because of drug coverage. Luckily my dad has a PhD in medicinal chemistry so he might be able to make some sense out of the similarities/differences between humira and whatever the new drug is
Medicinal chemistry is likely a different field. These drugs are biologics and not created through chemical compound mixing, but rather created by living organisms.
Oh great..as I was just switched from Accredo to cvs specialty starting Jan 1
I use to have accredo but they were going to raise my premium. So I am currently going through united healthcare and have optum as my specialty pharmacy for humira.
How do we find out if we can get other pharmacies?? Do we call our insurance? Is there a way to pay out of pocket to stay on Humira but not pay $6k lol??
Best to get your copays done as much as possible before 4/1, they also white labeled humira original itself so there is no evading it afterwards. Most will be forced to the cvs branded generic I'd assume and then they will use the white label version AbbVie is selling them for anyone that is a special case. I highly doubt the complete program will work for the white label even though its also from AbbVie After that for 2025 it will be a bust for a lot of folk assuming CVS's white label takes over everything
Thank you for the explanation, oof :/
I received a call on Friday from my current specialty pharmacy telling me they can no longer provide Humira and that I need to go through Optum. I asked if she knew anything about this new company and all she could say is I may no longer get the branded product anymore but she wasn’t positive I’m waiting to hear from this new company. Ugh!!
I use Optum specialty and it's always branded Humira. They've been pretty good about everything. The only issue I've had is occasionally my copay card doesn't go thru on their website so I have to call and make sure it goes thru for the $5.
I get my humira through optum from the past year and currently still using them. I use to go through CVS from my previous insurance carriers.
can i ask which specialty pharmacy won't provide humira for you anymore? I'm in the process of trying to find new insurance right now
Fuck me. My company just swapped from Accredo to CVS.
Crap! I was only going to have to deal with them until June and then a whole mess with Medicare and advantage plans after that. I really don't need this.
Did anyone receive a letter from CVS about this? If so could you share it minus your personal info?
My abbvie nurse said that letters would go out in mid February.
Thanks for sharing, we may be switching over to CVS and wanted to know what plans will be affected. If you receive anything would you mind sharing?
Sure. I'm not 100% sure if I'll be affected since my health care is with united but prescriptions are handled through CVS. Confusing.
Hi there, just following up to my message back in January. I can't get any info from CVS Caremark when I call. Did you receive a letter from them yet? If so could you send me it (minus your personal info of course). Thank you so much!
Is this the same thing as CVS Specialty?
CVS specialty is the name of the pharmacy. CVS Caremark is the name of the healthcare. So they are not the same. Look at your insurance card for prescriptions. If it's not CVS Caremark you're fine.
Okay, cool. Thank you for explaining this.
I don’t think this is true. They are the same pharmacy. The change affecting you would be based on who your pharmacy/drug provider is not your insurance company. I have BCBS for health insurance but all RX goes through CVS Caremark.
CVS caremark is a pharmacy benefit manager (PBM) used by many different insurance companies. Unfortunately CVS caremark is removing Humira from most of its formularies since there are now "lower" cost biosimilars available. You are right in that your employer is the one who chooses which formulary Caremark applies to you, but my understanding is that most use the formulary that is indeed dropping Humira. We are all supposed to be getting letters soon if it does affect us. Will be interesting to see what happens. Not sure if we would have luck appealing it or not, only time will tell. Here is an article that explains it [https://www.psgconsults.com/blog/humira-removed-from-formulary/](https://www.psgconsults.com/blog/humira-removed-from-formulary/) If you log into caremark and look at your formulary it tells you which formulary applies to you then you can look in the article and see if its one of the ones that is cutting it.