Health New England Shifts Coverage from Humira to Lower-cost Biosimilars

SPRINGFIELD — As part of its continued commitment to making healthcare more affordable and accessible, Health New England is shifting its coverage of Humira — a biologic medication used to treat inflammatory conditions such as rheumatoid arthritis, Crohn’s disease, and plaque psoriasis — to FDA-approved biosimilar medications for members of its commercial health plans.

Biologic medications are made from natural and living organisms. Biosimilars are designed to have the same efficacy and safety as the biologics on which they are based at a fraction of the cost. Using biosimilar medication is akin to using generic medication in place of a name brand medication. This shift is part of Health New England’s commitment as a not-for-profit health plan to manage healthcare costs for all.

This move aligns with industry-wide efforts to drive down medication costs while maintaining high-quality care and positive patient outcomes. Health New England commercial members taking Humira will be asked to switch to FDA-approved alternative biosimilars, either Amjevita by Nuvaila or Hadlima, effective July 1.

“Biologic medications like Humira are complex treatments that carry significant cost. Its biosimilars provide a meaningful opportunity to enhance affordability for the healthcare ecosystem while members continue to get the full benefits of the medication,” said Gary Tereso, director of Pharmacy Services at Health New England. “As part of our ongoing commitment to our members and employer groups, we are focused on ensuring access to high-quality, cost-effective therapies for all Health New England members.”

Health New England is communicating directly with affected members, providers, and pharmacies to ensure a smooth transition, and will continue to monitor the evolving biosimilar market to support member needs and manage healthcare costs.