Optum Rx to pull Humira from some of its preferred formularies: report

UnitedHealth Group's Optum Rx will join its peers in the big three pharmacy benefit managers by pulling Humira from some of its preferred formularies, according to a report from Reuters.

Instead, it will recommend a cheaper biosimilar as the preferred option beginning Jan. 1, 2025, according to the article. Amgen's Amjevita biosimilar will be among the options.

CVS Health's Caremark announced similar steps in April, and Cigna's Express Scripts unit followed suit in August. Prescriptions for Sandoz's Hyrimoz biosimilar spiked after CVS removed Humira from its major commercial formularies, according to a report in Stat.

Reuters reported that UnitedHealth will continue to offer Humira coverage until the biosimilars are awarded an interchangeable designation from the Food and Drug Administration, which is expected in 2025.

Pharmacy benefit managers have highlighted biosimilars as key tools to bring down the cost of pricey branded products. Humira, in particular, has been a critical target in this effort, as it is one of the most popularly used brand drugs in the U.S.

Optum Rx was the first PBM to put Humira biosimilars on its formulary in early 2023.