Here’s some cost-saving news for MedBen Rx clients who use Ventegra as their processor.

On July 1, 2023, biosimilar products were released for the popular and expensive anti-inflammatory therapy, Humira. A 30-day supply of Humira, which is used to treat a variety of conditions from Crohn’s to rheumatoid arthritis and psoriatic arthritis, can cost between $6,000 and $12,000 per month depending on the dose.

With the introduction of these biosimilars, MedBen Rx has been working diligently to secure affordable access to these products, and we have been successful in negotiating a significantly discounted price directly with one of the biosimilar manufacturers. Through this program, MedBen Rx clients will be able to obtain that same formulation of the drug for under $1,000 per month. Depending on the usage of the drug, this can result in significant savings for plans and members alike.

Effective January 1, 2024, MedBen Rx is recommending that clients cover the biosimilar manufactured by Fresenius Kabi USA (adalimumab-aacf). 340B-eligible hospital clients and clients not working through MedBen Rx and our processor, Ventegra would not be subject to this recommendation.

We have arranged for this pricing to be accessible through our specialty pharmacy partner, Perigon Pharmacy 360, who will be coordinating distribution with the manufacturer.

Conversion to the biosimilar from Humira will require a new prescription, and the team at Perigon Pharmacy will work with your members and their prescribers to obtain the necessary documentation for the preferred product. In addition, Perigon has committed to help members obtain available copay assistance to further reduce their out-of-pocket costs.

We are sending out a benefit confirmation form for clients to complete and encourage this important cost-saving move. If you have any questions, please contact your Account Manager.