​​Effective January 1, 2025, Humira® (adalimumab) or adalimumab biosimilar will no longer be preferred on the Independence Blue Cross (IBX) Value, Select, and Premium Formularies. New prescriptions are now required for patients (our members) on Humira (adalimumab) or adalimumab biosimilars to access the preferred biosimilar indicated below.

Note: A new prior authorization to transition from Humira to the new preferred biosimilar is not needed.

Value and Select Formularies

IBX recently added the biosimilar adalimumab-aacf as the preferred product on the Value and Select Formularies.

• For members on these formularies, IBX is working with PerformSpecialty, a separate company, to deliver adalimumab-aacf and offer patient assistance with enrolling in the Fresenius Kabi patient support program and the KabiCare financial assistance program. Members may also continue to use their current pharmacy.
• Please note that some IBX members have a mandatory specialty benefit and must use Optum Specialty Pharmacy, an independent company. IBX recently sent a letter containing this information to practices with impacted members.
• When switching a patient (member) from Humira to adalimumab-aacf, the pharmacy cannot automatically make the substitution without provider approval. The pharmacist needs a new prescription.

Instructions for Value and Select Formularies

1. Submit a prescription for “adalimumab-aacf" and make sure to add the 4-letter suffix “aacf" to adalimumab (this will prevent callbacks or clarification requests).
   
   Please note that it is not sufficient to write “OK to substitute." Adding the 4-letter suffix to adalimumab is necessary to specify the biosimilar product being requested for the patient.


2. ​ For patients interested in using PerformSpecialty, please send a prescription to PerformSpecialty or call PerformSpecialty at 1-855-287-7888 to initiate the transition to adalimumab-aacf.
   ​
   PerformSpecialty will coordinate with your patient to deliver adalimumab-aacf to their home and assist the patient in enrolling in the Fresenius Kabi and KabiCare Patient Support Programs.


3. Patients who are required to use Optum Specialty Pharmacy will require submission of a new prescription for the preferred formulary product, adalimumab-aacf.

Premium Formulary

IBX recently added Amjevita™ as the preferred product on this formulary.

Prescription instructions for Premium Formulary

1. ​Write the prescription for Amjevita. It is not sufficient to write “OK to substitute."


2. ​ Please submit a new prescription for the new preferred formulary product, Amjevita. Some of your patients are required to use Optum Specialty Pharmacy.

What is adalimumab-aacf?

Adalimumab-aacf is the unbranded name for Indicio®. Both the branded and unbranded versions of adalimumab-aacf are made by Fresenius Kabi. Adalimumab-aacf is a tumor necrosis factor (TNF) blocker and a biosimilar to Humira. As a monoclonal antibody, it binds TNFα and blocks its general cytokine effects. These are responsible for mediating the inflammatory process involved with TNF-mediated cellular functions associated with a range of autoimmune disorders.

As a biosimilar to Humira, adalimumab-aacf is considered highly similar to and has no clinically meaningful differences than its reference product Humira (original biologic).^1,2 This means that you can expect the biosimilar to provide similar safety and efficacy as the reference product. Every biosimilar is approved by the FDA and has no clinically meaningful differences in terms of treatment risks and benefits as its reference product.

For more information refer to the FAQs about adalimumab-aacf.

Learn more

If you have questions about the formulary changes, please contact our pharmacy benefit manager at 1-888-678-7012.

For more information about biosimilar and/or formulary changes, refer to the Pharmacy & IRA resource page found on the IBX Provider News Center.

¹Adalimumab-aacf. Package insert. Fresenius Kabi. June 2024. Accessed October 22, 2024. biospecialized.com/wp-content/uploads/2023/11/BLA-761255-Adalimumab-aacf_PI-16Nov2023-1.pdf

²Fresenius Kabi. Our Products & Expertise - Biospecialized. Published September 17, 2024. Accessed October 22, 2024. biospecialized.com/biosimilar-products-expertise/

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