Upcoming changes to preferred biologic medications
Humira and Stelara changes for Commercial Fully Insured lines of business effective January 1, 2026
At BCBSNE, we are committed to helping our members with complex medical conditions receive the care they need in the most cost-effective manner.
Starting Jan. 1, 2026, we will be removing Humira and Stelara from the following prescription drug lists: NetResults Performance, TraditionalRxList, ValueRxList and BluePride RxChoices. There are multiple biosimilar options available which are, in many cases, interchangeable with Humira or Stelara and will work the same.
Affected medications: Humira (adalimumab) and Stelara (ustekinumab).
Preferred biosimilar products:
Humira:
Adalimumab-aaty
Adalimumab-adaz
Hadlima
Simlandi
Stelara:
Selarsdi
Steqeyma
Yesintek
Implementation details:
Starting Jan. 1, 2026: Patients currently on Humira or Stelara will need to switch to a preferred biosimilar alternative for treatment.
New therapy patients: Patients new to therapy will need to use a preferred biosimilar agent, per policy.
Preauthorizations: Current preauthorizations extending beyond Jan. 1, 2026, will be transitioned to the biosimilar equivalent medication. Upon expiration, a new preauthorization request for the biosimilar medication will be required as is required today.
Please note that these changes do not apply to Medicare Advantage and Medicare Part D members.
If you have questions, please reach out to your account team.
Wellness program for fully insured and ChamberChoice groups
Did you know your employees enrolled in the health plan can access a wellness rewards program at no extra cost?
This exclusive program, powered by Vitality, offers tools and resources to support healthier lifestyles. When employees actively participate, they often experience improved well-being—and reduced health care costs. Best of all, participants can earn over $175 in preconfigured rewards!
Encourage your team to register and engage with the program to make the most of this valuable benefit! If you have questions, reach out to your account team to learn more.
You are receiving this email because you are identified as an employer.
Vitality Group is an independent company providing workplace wellness services for Blue Cross and Blue Shield of Nebraska, an independent licensee of the Blue Cross Blue Shield Association.
