Preferred products for infliximab

January 12, 2022

​​Effective February 15, 2022, the following drugs will be designated preferred infliximab products for members enrolled in Independence Commercial plans:

  • Remicade® (infliximab)
  • Unbranded Johnson & Johnson infliximab
  • Inflectra® (infliximab-dyyb)

How will this affect my patients?

Independence selected Remicade as a preferred product to maintain continuity of care for our Commercial members with chronic conditions who wish to remain on the reference product. By adding two other preferred infliximab products, we are giving providers a wider selection of treatment options. 

New coverage requests for infliximab for Commercial members will only be approved for the three preferred products, in accordance with our medical policy.

Commercial members who are currently approved to receive a nonpreferred infliximab product (e.g., Avsola®, Ixifi®, Renflexis®) can continue their regimen. They will not be required to transition to a preferred product. However, if the provider and member want to switch to a preferred product, they may do so.

At this time, these changes will not apply to members enrolled in Medicare Advantage plans. Information on preferred products for these members will be announced in a future article on the Provider News Center.

Why are these changes happening?

Independence is constantly evaluating best practice standards and industry trends to help manage specialty drug costs. Remicade is a highly used biologic that is a significant contributor to specialty drug spend. The U.S. Food and Drug Administration (FDA) has approved several biosimilars for Remicade. According to the FDA, biosimilars have no clinically meaningful difference from FDA-approved reference products in terms of safety and effectiveness.*

Designating preferred products allows Independence to take advantage of the growing availability of biosimilars, as well as the competition between biosimilars and reference products. This competition may reduce costs and expand members' access to more affordable therapies.

Policy updates

The Independence Commercial medical policy for infliximab will be updated to reflect the new coverage criteria for preferred products. Medical policy #08.00.34q: Infliximab and Related Biosimilars will be posted as a Notification on January 14, 2022, and will go into effect February 15, 2022.

To view the Notification for this policy, please visit our Medical and Claim Payment Policy Portal.

 

*U.S. Food & Drug Administration. “Biosimilar and Interchangeable Products." 2017. Available from: https://www.fda.gov/drugs/biosimilars/biosimilar-and-interchangeable-products