Biosimilars offer an alternative to pricey medications
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A growing class of medications known as biosimilars is making the treatment of complex and chronic diseases less expensive than ever before, in a safe and effective manner.
Biologics vs. biosimilar drugs
The basics of biologics
Biologics are complex pharmaceutical drugs made from natural sources, living sources and microorganisms. They can be made of living cells, tissues, sugars and proteins. Biologics are used in a wide range of treatments, such as:
- Vaccines
- Blood and blood products
- Gene therapy
- Tissues
Some of the most-used biologic drugs treat various autoimmune diseases, cancers and diabetes. Because of the way they are manufactured, biologics can be extremely expensive and often require approvals for use from both your doctor and health insurance company.
The basics of biosimilars
Biosimilars are close copies of the biologic they are meant to replicate. Similar to a generic medication, biosimilars offer lower cost alternatives to expensive biologic medications, without sacrificing effectiveness or safety.
To be approved by the U.S. Food and Drug Administration (FDA), studies must show that biosimilars are as safe and effective as the original biologic they are meant to replicate. Biosimilars are made from the same types of sources and provide the same benefits when treating diseases and medical conditions without new or worsening side effects.
Check your prescription drug coverage
The best way to know your benefits, check your drug formulary and save on prescription drug costs is to log in to myWellmark®. When you log in, you can see your out-of-pocket costs before you pick up your prescription and easily check copays and deductibles.
Are biosimilars common?
More than 40 biosimilars have been approved by the FDA since 2015 and more are in development. Many biosimilars are injected or infused by a provider and are currently covered under medical benefits. However, more recently, biologic medications you can give yourself at home have become available, such as Humira®. This popular medication — and its biosimilars — treat many autoimmune conditions, including rheumatoid arthritis, psoriasis and Crohn’s disease.
There are currently ten biosimilars on the market that replicate Humira, at a fraction of the cost. This can mean savings at the pharmacy, depending on your plan. It's important to check your coverage and drug formulary in myWellmark prior to visiting the pharmacy to know how much you’ll pay. In some cases, you may need to pick up your biosimilar prescription at a specialty pharmacy.
What if a biosimilar is available for my prescription drug?
If a biosimilar becomes available for a medication you’re currently taking, there may be changes to your prescription drug coverage. If this happens, you will receive a notification from your health plan with more information.
Do biosimilars require prior authorization?
Some prescription drugs — and certain amounts of some drugs — require an approval called prior authorization before they can be covered by your health insurance benefits. Register or log in to myWellmark to determine if a biosimilar requires prior authorization.
As always, it's important to have an open, honest relationship with your provider so you can advocate for your own health and understand prior authorization requirements.
Stay up-to-date on your prescription drug benefits
Register or log in to myWellmark to check your drug coverage and benefits. Or, find more information on the prescription drug tag to better understand your benefits.