We want to make you aware of upcoming changes related to Humira (adalimumab), Simlandi, and Stelara (ustekinumab). We’ve notified impacted members of these changes as well. 

Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct

Effective March 1, 2026, for our Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, and Tufts Health Direct products, Simlandi will be added to the formulary at preferred status with prior authorization required, while Humira and all other FDA-approved biosimilars will be designated as non-preferred, non-formulary.

Patients currently utilizing Humira will not need a new prior authorization request for Simlandi. However, we strongly recommend that you write a new prescription for Simlandi to make the transition as seamless as possible.

Tufts Health Together 

Effective Jan. 5, 2026, several adalimumab and ustekinumab biosimilars will be preferred on MassHealth’s formulary. Humira and Stelara will continue to be covered through March 31, 2026, to allow Tufts Health Together members sufficient time to transition to one of the following: 

  • Preferred biosimilars to Humira: Hadlima (adalimumab-bwwd) and adalimumab-adaz
  • Preferred biosimilars to Stelara: Pyzchiva (ustekinumab-ttwe) and Imuldosa (ustekinumab-srlf). In addition, Steqeyma (ustekinumab-stba) will be accessible at parity with preferred ustekinumab biosimilars.

Effective April 1, 2026, Humira and Stelara will be designated as non-preferred and will be subject to a step therapy requirement: members will be required to have tried and failed all preferred biosimilars before coverage will be granted for Humira or Stelara. A new prior authorization will be required for patients who have not switched to a preferred biosimilar.

Hadlima and adalimumab-adaz, and Pyzchiva and Steqeyma are approved by the Food and Drug Administration (FDA) as interchangeable with Humira and Stelara respectively, and can be substituted at the pharmacy without requiring a new prescription. Imuldosa is not FDA-approved as interchangeable with Stelara and will therefore require a new prescription.