Premera Makes 2025 the Year for Biosimilars

A recent report from the Blue Cross Blue Shield Association highlights how brand-name drugmakers are using tactics to delay the availability of generics, keeping prices high and limiting access to affordable medications. When lower-cost alternatives are blocked, patients pay the price.

What we’re doing
In 2024 the Premera Blue Cross Blue Shield of Alaska pharmacy team conducted outreach to provider groups who were prescribing brand-name Humira (adalimumab) to their patients and asking that they change the prescription to the Humira biosimilar.

Effective January 1, 2025, we no longer allow new starts on Humira. Instead, a biosimilar must be prescribed. Currently we are at 70% biosimilar use, ahead of our formulary change on July 1, 2025 when we’ll change our formulary to prefer biosimilars for existing members on Humira.

Need a refresher on biosimilars? Watch Healthcare Asks: Biosimilars.

Why this matters
Biosimilars are important for managing drug spending and reduce reliance on rebates to manage cost. Taking a stance on preferring biosimilars first will help keep the overall cost of drugs down.

Where we’re headed
It doesn’t end with Humira. Premera has a track record of covering biosimilars under the medical and pharmacy benefits. Biosimilars of Avastin, Herceptin, and Rituxan are some of the examples.

At Premera, we believe every person deserves access to the medications they need, at a price they can afford. We’re committed to advocating for policies and solutions that remove barriers, and support transparency because good healthcare should be available, accessible, and affordable for all.

Read more from BCBSA on how these practices impact patients and what needs to change.