Feb 06, 2024
Starting on April 1, 2024, the Advanced Control Plan – Aetna formulary will no longer include Humira (adalimumab). Instead, members will have coverage for a selection of biosimilar adalimumab products. These products are lower cost than Humira.
This change impacts all Small Group Aetna Funding AdvantageSM and Aetna® Fully Insured 51-100 plans, which all use the Advanced Control Plan – Aetna formulary.
Members’ prior authorizations will automatically transfer to an available biosimilar product for any claims after April 1st, 2024. A new prescription for the biosimilar will be needed, but many pharmacies, including CVS Specialty® Pharmacy, will contact the provider to handle the change on the member’s behalf.
Aetna will notify impacted plan sponsors of this change in February, using this letter.
Contact your Amwins Connect Sales Representative for more information.
