CommercialCoverageHigh impact
Humira Will Be Removed from Select Formularies--Effective April 1, 2024
CareFirst BlueCross BlueShield·Rheumatology, Gastroenterology, Dermatology +2 more·Pharmacy
Effective date
Apr 1, 2024
We identified it
Jun 20, 2026
Summary
Effective April 1, 2024, Humira will be removed from F2, F3, and FEHBP formularies but will remain covered on Exchange, F1, and F3 Choice formularies. Biosimilars like Hyrimoz will continue to be available across all formularies.
Action Required
By April 1, 2024: Billing team must verify formulary coverage before prescribing Humira - check if patient has F2, F3, or FEHBP plans and recommend biosimilars like Hyrimoz instead. Update prior authorization workflows to reflect formulary changes. For patients on affected formularies, coordinate with providers to transition to covered alternatives to avoid claim denials.