Beginning June 22, 2024, coverage of Humira (adalimumab) through PacificSource Health Plans will change to other, biosimilar formulations. This change applies to commercial (Employer and Individual & Family) plan members.
Questions and answers
Will I still be able to prescribe Humira?
Humira is the brand name of the active ingredient adalimumab, which is now available in other, more cost-effective formulations, so we will no longer provide coverage for the brand Humira after June 22, 2024.
Will patients need a new prescription and prior authorization?
Yes, patients will need a new prescription. Providers can send prescriptions to their patients’ pharmacies.
All formulations of adalimumab require prior authorization. PacificSource will honor existing authorizations for members switching directly from Humira.
Which adalimumab biosimilars will be covered?
- Hadlima (Organon)
- Hyrimoz (Cordavis manufacturer only)
- Adalimumab-adaz (Sandoz)
If you have questions, please call our Pharmacy Help Desk at 844-877-4803, Monday through Friday, 8:00 a.m. to 5:00 p.m. You can also email ProviderNet@PacificSource.com.