MedicaidPrior AuthMedium impact
MassHealth updates to preferred Stelara biosimilars
Harvard Pilgrim Health Care·MA · Dermatology, Gastroenterology, Rheumatology·Pharmacy
Effective date
Jul 1, 2026
We identified it
Jun 20, 2026
Summary
MassHealth is changing preferred Stelara biosimilars for Tufts Health Together members effective July 1, 2026. Starjemza and ustekinumab-aekn will become preferred, while current preferred biosimilars (Imuldosa, Pyzchiva, Steqeyma) will require step therapy after trying the new preferred options first.
Action Required
By June 30, 2026: Billing team must update prior authorization protocols for Tufts Health Together members requiring Stelara biosimilars. Update system to reflect Starjemza and ustekinumab-aekn as preferred agents, and ensure step therapy requirements are implemented for Imuldosa, Pyzchiva, and Steqeyma. Notify providers that existing authorizations for non-preferred products will automatically transfer to preferred products on July 1, 2026.