Medicare Prescription Payment Plan

[rmhaire]

1. I'm not wrong. If I post it, I am right. I don't comment if I am not 100% sure.
2. Due to *** agents like you, I've got the docs who prescribe Humira and Enbrel in DFW sending me clients, getting their patients the best coverage available. Over 65 and Under 65.
2. I won't speak for everyone else, but I've earned the ego. I was a broke single mom with 2 kids feeding 3 people on $50 a week when I started. Last week, I got the BCBSTX #1 Over 65 award. Again.

View attachment 12022

Congratulations ... And that's why I stay out of Texas. You'd kick my ass.

 

[somarco]

You expect me to read all that?

There is a search function . . . or you can wait on Mom to post something.

 

[somarco]

This is actually for the biosimilar subsitution rule that is going to be implemented on 1/1/25.

OK, I will be ready when January rolls around.

 

[rmhaire]

There is a search function . . . or you can wait on Mom to post something.

Or you.

 

[somarco]

Ridgefield, Conn., October 2, 2023 – Boehringer Ingelheim announced today that Adalimumab-adbm injection, the company's interchangeable* biosimilar to Humira® (adalimumab), is now available at a low wholesale acquisition cost (WAC). Adalimumab-adbm is approved to treat multiple chronic inflammatory diseases and will be priced at an 81% discount to Humira.

https://www.boehringer-ingelheim.com/us/human-health/skin-and-inflammatory-diseases/biosimilars/low-wac-interchangeable-biosimilar-now

 

[kgmom219]

There is a search function . . . or you can wait on Mom to post something.

Getting on a plane tomorrow. All 1500 pages are printed for me to...enjoy

 

[sman]

Ridgefield, Conn., October 2, 2023 – Boehringer Ingelheim announced today that Adalimumab-adbm injection, the company's interchangeable* biosimilar to Humira® (adalimumab), is now available at a low wholesale acquisition cost (WAC). Adalimumab-adbm is approved to treat multiple chronic inflammatory diseases and will be priced at an 81% discount to Humira.

https://www.boehringer-ingelheim.com/us/human-health/skin-and-inflammatory-diseases/biosimilars/low-wac-interchangeable-biosimilar-now

The Biosimilar Hyrimoz can be purchased in my area at CVS using GoodRx for $124.19 which is DRASTICALLY cheaper than Humira.

Cyltezo, the one referenced in your link, shows a price of $561.43 at Walgreens via GoodRx.

Not sure how these two may be different in their efficacy, but that's a big price difference.

 

[kgmom219]

The Biosimilar Hyrimoz can be purchased in my area at CVS using GoodRx for $124.19 which is DRASTICALLY cheaper than Humira.

Cyltezo, the one referenced in your link, shows a price of $561.43 at Walgreens via GoodRx.

Not sure how these two may be different in their efficacy, but that's a big price difference.

Its the FDA list.

The issue is how the substitutions can be done by the PBMs in 2025

 

[somarco]

Getting on a plane tomorrow. All 1500 pages are printed for me to...enjoy

Long flight to Hawaii?

 

[somarco]

Not sure how these two may be different in their efficacy, but that's a big price difference.

For approval, the manufacturer of a generic drug must demonstrate, among other things, that the generic is bioequivalent to the brand-name drug. By contrast, biosimilar manufacturers must demonstrate that the biosimilar is highly similar to the reference product, except for minor differences in clinically inactive components. Biosimilar manufacturers must also demonstrate that there are no clinically meaningful differences between the biosimilar and the reference product in terms of the safety, purity, and potency of the product (i.e., safety and effectiveness).

https://www.fda.gov/media/154912/download

Mom (or maybe the straight guy lol) can put this in English for the mere humans on the forum.

My understanding is the prescribing doc must write the Rx for the biosimilar. Pharmacy is not allowed to substitute.