Biosimilar Advocacy and Recommendations to Michigan Meridian Medicaid Prescribers for converting patient prescriptions for Humira and Stelara to biosimilars
Date: 11/24/2025
Dear Prescribing Healthcare Provider,
Effective on 11/01/2025, adalimumab-adbm (unbranded Cyltezo), an FDA approved biosimilar that is interchangeable with brand name Humira (adalimumab) will be a preferred option, covered without prior authorization, within quantity limits, for Michigan Meridian Medicaid members and all MI Medicaid beneficiaries.
The State of Michigan Medicaid Program, through the Michigan Department of Health & Human Services (MDHHS), will add this new preferred option to their biologic drugs available on the Common Formulary and Single Preferred Drug List (SPDL) effective on 11/01/2025. The Common Formulary and SPDL preferred and non-preferred drug products are covered by all MI Medicaid managed care organizations’ drug lists and formularies.
As a valued partner in patient care, we are committed to supporting both optimal clinical outcomes and sustainable healthcare practices. In alignment with these goals, on and after 11/01/2025 Meridian will encourage the transition of patients currently prescribed brand name Humira to the preferred alternative, adalimumab-adbm. Meridian will also encourage providers to prescribe adalimumab-adbm in place of brand name Humira to patients newly starting on therapy with adalimumab .
This transition reflects our dedication to ensuring access to effective therapies while promoting responsible stewardship of healthcare resources. Please review the information in this bulletin which contains information and resources to help support transition of Meridian patients from brand name Humira to biosimilar adalimumab-adbm.
Background: Humira and the Biosimilar Landscape
Humira has been an important treatment option in the management of numerous inflammatory and autoimmune disease states. The introduction of biosimilar products represents a significant advancement in expanding patient access to high-quality biologic therapies, improving disease outcomes, and reducing health care costs. Biosimilars are rigorously evaluated and approved by the FDA, demonstrating no clinically meaningful differences in safety, purity, and potency compared to their reference products.
Cost-Savings: The Economic Benefits of Biosimilars
Biosimilar products offer substantial cost-savings opportunities for the healthcare system. By transitioning to adalimumab-adbm, prescribing providers can help reduce overall drug expenditures while maintaining the same therapeutic outcomes as with brand name Humira. These savings can be redirected to other areas of patient care, enhancing the overall quality and reach of healthcare services.
Interchangeability: FDA Guidance and Clinical Equivalence
The FDA has granted interchangeability status to certain biosimilar adalimumab products, including adalimumab-adbm, indicating that they may be substituted for Humira at the pharmacy level without prescriber intervention. Clinical studies have confirmed that switching between Humira and its biosimilars does not compromise efficacy, safety, or incur a higher immunogenicity risk. The interchangeability designation underscores the confidence in biosimilars’ ability to provide identical clinical results for all FDA approved indications shared between products. Importantly, adalimumab-adbm is Citrate-free (CF) in all available formulations. The only FDA approved indications that brand name Humira does not share with adalimumab-adbm are the following: 1) treatment of ulcerative colitis in pediatric patients; 2) treatment of hidradenitis suppurative in pediatric patients; 3) treatment of uveitis in pediatric patients.
Action Request: Encouraging Transition to Adalimumab-adbm
We strongly encourage prescribing clinicians to consider transitioning appropriate patients from brand name Humira to the newly preferred biosimilar: adalimumab-adbm (unbranded Cyltezo). This approach aligns with best practices for cost-effective care and ensures continued access to high-quality therapy. Please review the tables below which provide further details of comparisons between adalimumab-adbm to Humira, adalimumab-adbm product & dosage forms availability, and specialty pharmacy details.
Indication | Adalimumab-adbm: Recommended Dosage | Adalimumab-adbm: Minimum FDA Approved Age | Humira (brand): Recommended Dosage | Humira (brand): Minimum FDA Approved Age |
|---|---|---|---|---|
Rheumatoid Arthritis | 40 mg every other week | 18 years | 40 mg every other week | 18 years |
Juvenile Idiopathic Arthritis | 10 mg every other week (10kg- <15 kg); 20 mg every other week (15kg - <30kg); 40 mg every other week (≥30 kg) | 2 years | 10 mg every other week (10kg- <15 kg); 20 mg every other week (15kg - <30kg); 40 mg every other week (≥30 kg) | 2 years |
Psoriatic Arthritis | 40 mg every other week | 18 years | 40 mg every other week | 18 years |
Ankylosing Spondylitis | 40 mg every other week | 18 years | 40 mg every other week | 18 years |
Crohn’s Disease (Adults) | 160 mg initial, then 80 mg at week 2, then 40 mg every other week | 18 years | 160 mg initial, then 80 mg at week 2, then 40 mg every other week | 18 years |
Crohn’s Disease (Pediatric) | 80 mg initial, then 40 mg at week 2, then 20 mg every other week (17–<40 kg); 160 mg initial, then 80 mg at week 2, then 40 mg every other week (≥40 kg) | 6 years | 80 mg initial, then 40 mg at week 2, then 20 mg every other week (17–<40 kg); 160 mg initial, then 80 mg at week 2, then 40 mg every other week (≥40 kg) | 6 years |
Ulcerative Colitis (Adults) | 160 mg initial, then 80 mg at week 2, then 40 mg every other week | 18 years | 160 mg initial, then 80 mg at week 2, then 40 mg every other week | 18 years |
Ulcerative Colitis (Pediatric) | Not FDA approved | Not FDA approved | 80 mg initial, then 40 mg at week 1, then 40mg at week 2, then 40 mg every other week or 20mg every week (20kg -<40kg 160mg initial, then 80mg at week 1, then 80mg at week 2, then 80mg every other week or 40mg every week (≥40 kg) | 5 years |
Plaque Psoriasis | 80 mg initial, then 40 mg every other week starting one week after initial dose | 18 years | 80 mg initial, then 40 mg every other week starting one week after initial dose | 18 years |
Hidradenitis Suppurativa (Adults) | 160 mg initial, then 80 mg at week 2, then 40 mg every week starting at week 4 | 18 years | 160 mg initial, then 80 mg at week 2, then 40 mg every week starting at week 4 | 18 years |
Hidradenitis Suppurativa (Adolescents) | Not FDA approved | Not FDA approved | 80 mg initial, then 40 mg at week 1, then 40 mg every other week (30 kg - <60kg) 160mg initial, then 80mg at week 2, then 40mg every week or 80mg every other week | 12 years |
Uveitis (Adults) | 80 mg initial, then 40 mg every other week starting one week after initial dose | 18 years | 80 mg initial, then 40 mg every other week starting one week after initial dose | 18 years |
Uveitis (Pediatric) | Not FDA approved | Not FDA approved | 10 mg every other week (10kg- <15 kg); 20 mg every other week (15kg - <30kg); 40 mg every other week (≥30 kg) | 2 years |
Table 1 References:
- Adalimumab-adbm Prescribing Information:
https://pro.boehringer-ingelheim.com/us/products/cyltezo/bipdf/adalimumab-adbm-us-pi
Accessed electronically: 10/07/2025 - Humira Prescribing Information:
https://www.rxabbvie.com/pdf/humira.pdf
Accessed electronically: 10/07/2025
Adalimumab-adbm NDC | Product Name [covered as preferred eff. 11.01.25] | Quantity Limit for Meridian Michigan Medicaid | Contents (all formulations are Citrate-free) |
|---|---|---|---|
00597057550 | ADALIMUMAB-ADBM (2 PEN) Adalimumab-adbm Auto-injector Kit 40 MG/0.4ML | N/A | Maintenance dose kit: 2 auto-injectors of 40mg/0.4mL with alcohol preps |
00597054522 | ADALIMUMAB-ADBM (2 PEN) Adalimumab-adbm Auto-injector Kit 40 MG/0.8ML | N/A | Maintenance dose kit: 2 auto-injectors of 40mg/0.8ml with alcohol preps |
00597055580 | ADALIMUMAB-ADBM (2 SYRINGE) Adalimumab-adbm Prefilled Syringe Kit 20 MG/0.4ML | N/A | Maintenance dose kit: 2 prefilled syringes of 20mg/0.4mL with alcohol preps |
00597056520 | ADALIMUMAB-ADBM (2 SYRINGE) Adalimumab-adbm Prefilled Syringe Kit 40 MG/0.4ML | N/A | Maintenance dose kit: 2 prefilled syringes of 40mg/0.4mL with alcohol preps |
00597058589 | ADALIMUMAB-ADBM (2 SYRINGE) Adalimumab-adbm Prefilled Syringe Kit 10 MG/0.2ML | N/A | Maintenance dose kit: 2 prefilled syringes of 10mg/0.2mL with alcohol preps |
00597059520 | ADALIMUMAB-ADBM (2 SYRINGE) Adalimumab-adbm Prefilled Syringe Kit 40 MG/0.8ML | N/A | Maintenance dose kit: 2 prefilled syringes of 40mg/0.8mL with alcohol preps |
Storage & Stability Notes:
- Supplied as sterile, preservative-free, citrate-free, solution for subcutaneous injection
- Needle caps on auto-injectors and prefilled syringes all contain natural rubber latex
- Must be stored refrigerated (36F-46F / 2C-8C). Do not Freeze. Protect from light.
- When traveling, may be stored at room temperature up to 77F (25C) for a period of up to 14 days
Table 2 Reference:
Adalimumab-adbm Prescribing Information:
https://pro.boehringer-ingelheim.com/us/products/cyltezo/bipdf/adalimumab-adbm-us-pi Accessed electronically: 10/07/2025
Starter Dose Kits and Initiation Prescriptions:
- The Michigan Meridian Medicaid formulary as of 11/01/205, State of Michigan Common Formulary as of 11/01/2025, and currently published prescribing information by the manufacturer (Boehringer Ingelheim) of adalimumab-adbm, will reflect that certain Starter Kit preparations are available, however, the manufacturer has recently discontinued production of adalimumab-adbm starter kit products and their associated NDCs.
- Prescriptions for Initiation of Therapy will require the pharmacy to dispense multiples of the maintenance dose kits which remain available and can be combined in order to achieve the dose required.
Pharmacy Name | Pharmacy NPI | Pharmacy Contact information (Address, Phone, Fax) |
|---|---|---|
AcariaHealth Pharmacy | 1073733408 | Address: 8715 HENDERSON RD. TAMPA, FL 33634 Phone: (800)-511-5144 Fax: (866)-458-9245 Website: https://www.acariahealth.com/ |
Pharmacy Advantage / Henry Ford Medical Center Specialty Pharmacy | 1073799276 | Address: 1191 SOUTH BLVD E. ROCHESTER HILLS, MI 48307 |
Wal-Mart Specialty Pharmacy | 1013934413 | Address: 2354 COMMERCE PARK DR. ORLANDO, FL 32827 Phone: (877)-453-4566 Fax: (866)-537-0877 Website: https://www.walmart.com/cp/specialty-pharmacy/4101489 |
Meijer Specialty Pharmacy | 1568818391 | Address: 8455 HAGGERTY RD. BELLEVILLE, MI 48111 Phone: (734)-391-2310 Fax: (734)-391-2365 Website: https://meijerspecialtypharmacy.com/ |
BioPlus Specialty Pharmacy | 1174517452 | Address: 376 NORTHLAKE BLVD. STE 1008. ALTAMONTE SPRINGS, FL 32701 Phone: (888)-292-0744 Fax: (800)-269-5493 Website: https://bioplusrx.com/ |
Conclusion
We appreciate your continued commitment to providing the highest standard of care for our mutual patients and Michigan Meridian Medicaid members. Our pharmacy team is available to support transition to biosimilar therapy with adalimumab-adbm and assist with overcoming any barriers encountered. We understand that all healthcare providers play a pivotal role in advancing patient care, improving health outcomes, and working towards sustainability of our healthcare system.
If you have any questions or require additional support regarding this transition, please contact our clinical support team for Michigan Meridian Medicaid, at email MiMarketPharmacy@Centene.com, available Monday to Friday, 8AM to 6PM EST.
Thank you for your partnership in this important effort!
Sincerely, Michigan Meridian Medicaid