Thứ Sáu, 8 tháng 8, 2025

What's going on with specialty drugs being dropped mid-year?

Last year, I was prescribed Humira and it worked great.

Starting in 2025, ExpressScripts said they would no longer cover Humira and that I needed to switch to adalimumab-adaz or another biosimilar. I spent 1-3 hours a day for a month on the phone with insurance, ExpressScripts, Accredo, or my doctor, and missed an entire month of doses before I finally got my prescription. The biosimilar caused an itchy rash for days, something Humira never did.

Today, Accredo told me they are no longer carrying adalimumab-adaz and my doctor has to prescribe something else. This just happens to be right after I reached my out-of-pocket maximum for the year.

When I called ExpressScripts, they were confused because I’m pre-approved for adalimumab-adaz until Feb 2026. But both supervisors and a pharmacist at Accredo confirmed they’re not carrying it anymore.

Why would this happen? What’s going on behind the scenes? Does this kind of thing happen often?



https://ift.tt/yDYwsn3 Submitted August 08, 2025 at 03:20AM by gpops62 https://ift.tt/xigOKV3

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