Effective Sept. 1, the brand name drug Stelara will no longer be covered on the UnitedHealthcare commercial plan prescription drug list.
Search results for: biosimilar
August Updates from the ACR Insurance Subcommittee
The Insurance Subcommittee of the Committee on Rheumatologic Care is working on behalf of ACR members to address critical coverage and reimbursement challenges.
FDA Approves Ustekinumab-stba for All Forms & Dosages as Its Reference Product
Ustekinumab-stba (Steqeyma) now has FDA approval for all forms and dosages of its reference product, ustekinumab (Stelara), including a subcutaneous injection to treat pediatric patients with plaque psoriasis or psoriatic arthritis.
President’s Corner: The ACR Is on Your Side
Encouraging lawmakers to pass legislation and promote policies that positively affect rheumatologists, rheumatology care teams and those living with rheumatic disease is one of the most impactful ways the ACR advances its mission. The role of advocacy has never been more critical than in recent months, when we have seen an unprecedented number of executive…
Aetna Implements Specialty Pharmacy Requirements
On July 1, Aetna launched its new Combined Benefit Management Drug List, effectively moving romosozumab-aqqg (Evenity) and infliximab (Remicade) to pharmacy-only coverage for most fully insured commercial plans. The ACR has contacted Aetna leaders to raise concerns about patient access to these therapies.
The ACR Calls on CMS, OMB to Reduce Burdensome Healthcare Regulations
In response to agency requests for feedback on how to streamline regulations and reduce administrative burden on Medicare program stakeholders and small business owners, the ACR called for the removal of certain regulations related to prior authorization, pharmacy benefit managers and Medicare Part B and Part D access.
ACR Executive Committee Holds Meetings with Heads of FDA, CMS
As in past administrations, members of the Executive Committee scheduled meetings with leaders of the Food & Drug Administration and Centers for Medicare & Medicaid Services to discuss ACR policy priorities and agency agendas.
ACR Monitoring HHS Workforce Reductions, Function Consolidations
Changes announced April 1 will cut 10,000 positions at the U.S. Department of Health & Human Services and consolidate many department functions. The ACR is monitoring how these changes may impact regulatory issues of concern to ACR members.
President’s Corner: The Practicing Rheumatologist
Independent, community-based rheumatologists and rheumatology professionals represent a critical part of the ACR and ARP. My immense respect for clinicians grew while watching my husband, who joined an independent practice after completing rheumatology fellowship. With admiration, I saw how he and his two dedicated partners cared for patients while simultaneously managing overhead and striving to…
March Updates from the ACR Insurance Subcommittee
The Insurance Subcommittee is working on behalf of ACR members to address underwater formulary requirements for biosimilars, mandated switches to biosimilars, evaluation and management downcoding and more.
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