On Feb. 1, UnitedHealthcare (UHC) enacted a new policy designating Avsola and Inflectra as the preferred infliximab products for UHC commercial plans. Patients on Remicade or Renflexis may continue using these products for the duration of their current prior authorization; however, they will be required to switch when the authorization expires. Moving forward, coverage for non-preferred products will only be considered for patients who have failed a 14-week trial of both preferred products or who have a history of intolerance, contraindication or adverse event to both preferred products.
ACR leaders recently spoke with UHC and urged it to allow existing patients to continue on their current medication. However, since UHC remains committed to forced switching, the ACR has proposed additional exceptions criteria for patients’ protection. UHC is considering the ACR’s requested changes and we hope to see future modifications to this policy.
For questions regarding this policy or other insurance coverage concerns, contact [email protected].
