UHC Formulary Change Impacts Coverage for Ustekinumab

UnitedHealthcare (UHC) recently announced changes to its commercial pharmacy plan that will impact coverage for patients on ustekinumab (Stelara). Effective Sept. 1, the brand name drug Stelara will no longer be covered on the UHC commercial plan prescription drug list. Patients will be required to use either of the preferred alternatives, biosimilar drugs Steqeyma or Yesintek.

All patients will be required to switch to one of the preferred biosimilars, regardless of prior authorization status; however, all current prior authorizations will automatically carry over to the biosimilar.

For more information about this policy change or to request assistance with other practice or insurance issues, please contact [email protected].