Biosimilar Medication Formulary Updates

Sep. 2025Pharmacy Updates

Updates to formulary biosimilar medications for denosumab, eculizumab, and ustekinumab products

In ongoing efforts to improve the value and affordability of health care benefits for our members, UPMC Health Plan has implemented biosimilar medication formulary updates for denosumab, eculizumab, and ustekinumab products. Effective dates for these changes are as follows.

  • UPMC for Life (Medicare/Special Needs Plan):
    • Part D formularies effective Sept. 1, 2025
    • Part B policies effective Sept. 10, 2025
  • UPMC Health Plan (Commercial/Exchange) and UPMC for Kids (CHIP): Formularies effective Oct. 1, 2025
  • UPMC for You and UPMC CHC: Effective Oct. 1, 2025

For full details on these changes, please refer to pages 18-19 in the September 2025 edition of Provider Partner Update.

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