Innovation & Insights

Quality Care, Better Value: How Biosimilars Are Improving Healthcare Affordability

28 July 2025

 

Providence Health Plan transitions to biosimilar alternatives for Humira and Stelara in summer 2025

Providence Health Plan is committed to balancing exceptional care with responsible cost management, and we’re excited to announce our transition to biosimilars for two high-cost specialty medications. Effective July 1, 2025, for Stelara and August 1, 2025, for Humira, Providence Health Plan will be removing these brand-name medications from our commercial formulary and transitioning to FDA-approved biosimilar alternatives. 

This carefully timed decision reflects our promise to know, care for, and ease the way of those we serve by ensuring access to the most cost-effective treatments without compromising quality of care. 

The Right Decision at the Right Time 

Our approach to biosimilars has been deliberate and member-focused from the beginning, our summer 2025 timing allows us to make the best possible choice for members while waiting for the biosimilar market to mature and develop better options. 

The biosimilar market typically needs about three years to develop meaningful savings through competition. By timing our transition now, we’re taking advantage of a more developed marketplace with multiple product options and better pricing. This wasn’t delay – it was patient planning that now benefits everyone we serve. 

Our formulary decisions consider all related medications, including important treatments like Skyrizi and Rinvoq that serve similar patient populations. This thoughtful approach ensures we’re making decisions that benefit our entire membership while maintaining access to critical medications.

Delivering Real Savings Through Smart Healthcare Management

Both Humira and Stelara rank among the most expensive prescription medications on the market today. Stelara, indicated for the treatment of Crohn’s disease, psoriasis, psoriatic arthritis and ulcerative colitis, carries a substantial cost burden that impacts healthcare affordability. Similarly, Humira’s high cost has made it a priority target for biosimilar alternatives.

The introduction of FDA-approved biosimilars for these medications creates competition and opportunities for meaningful cost savings that will directly benefit our members through our transparent pass-through pharmacy model.  

This approach aligns with our mission and reflects our commitment to making quality healthcare more affordable and accessible for the communities we serve. 

Your Safety and Care Quality Come First 

Member safety and care quality remain our highest priorities. Every biosimilar medication added to our formulary is FDA-approved and clinically proven to be as safe and effective as the original medications. 

The FDA defines a biosimilar as a biological product that is highly similar to an FDA-approved biologic and used in the prevention or treatment of disease. While not chemically identical, a biosimilar has no clinically meaningful difference from the reference product. It is FDA-approved for use after rigorous evaluation and testing demonstrated by the manufacturer. 

These alternatives deliver the same therapeutic benefits at a fraction of the cost. Our clinical teams have thoroughly evaluated these medications to ensure they meet the exceptional standards you expect from Providence Health Plan. 

Dedicated to PHP Members  

This transition represents our ongoing commitment to responsible healthcare management while maintaining clinical excellence. By embracing biosimilars at the right moment, we’re working to ensure healthcare benefits remain sustainable and accessible for everyone we serve. 

Our member-first approach to healthcare decision-making continues to guide us as we navigate an evolving pharmaceutical landscape, always with the goal of delivering exceptional care while making healthcare more accessible and affordable for all.