CVS Caremark will update its commercial formularies to expand use of lower-cost biosimilars and prefer certain interchangeable products over reference brands.
The changes, effective July 1, include shifting coverage from Stelara to interchangeable biosimilars Pyzchiva and Yesintek, with most members paying $0 out of pocket, according to a May 5 company news release.
The pharmacy benefit manager is also expanding biosimilar coverage across specialty categories, including multiple sclerosis and rare blood disorders, with alternatives to drugs such as Tysabri and Soliris.
The move follows a broader pattern among the nation’s largest PBMs of steering formularies toward biosimilars — particularly those marketed by their own affiliated, private-label businesses. CVS Health operates Cordavis, Cigna’s Evernorth runs Quallent Pharmaceuticals and UnitedHealth Group’s Optum Rx launched Nuvaila, each with preferred biosimilar products on their respective PBM formularies.
The formulary shift also comes as the FDA has moved to accelerate biosimilar development, issuing draft guidance in October 2025 that eliminates routine requirements for comparative efficacy studies and simplifies how biosimilars gain interchangeable status with brand-name biologics.
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