CommercialCoverageMedium impact
Coverage changes for Remicade and biosimilars
Harvard Pilgrim Health Care·Rheumatology, Gastroenterology, Dermatology·Provider Newsletter
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Starting January 1, 2026, Point32Health (Harvard Pilgrim and Tufts plans) will change preferred infliximab products from Remicade to biosimilars Avsola and Inflectra. Remicade and unbranded infliximab will become non-preferred, but patients can switch to preferred products without new prior authorization.
Action Required
Before January 1, 2026: Billing team must update preferred drug lists in billing system to reflect Avsola and Inflectra as preferred infliximab products for Point32Health plans. Update provider encounter forms and EMR templates to indicate Remicade and unbranded infliximab (J1745) are non-preferred. Notify providers that existing patients can switch to Avsola or Inflectra without new prior authorization requests.