WOONSOCKET, R.I. – CVS Health announced updates to its most common commercial template formularies that will expand the use of lower-cost biosimilars across multiple therapeutic categories, including changes effective July 1, 2026, that will prefer interchangeable biosimilars over select reference brands.
What changes are CVS Caremark making to its formulary?
Effective July 1, 2026, CVS Caremark will implement targeted updates to its most common commercial template formularies to increase adoption of U.S. Food and Drug Administration (FDA)-approved biosimilars with no clinically meaningful differences from the reference product and, in many cases, designated as interchangeable.
As part of these updates, CVS Caremark will transition from Stelara (ustekinumab) on its most common commercial template formularies to preferring lower-cost, interchangeable biosimilar alternatives— Pyzchiva and Yesintek. With this change, most members will pay $0 out-of-pocket for their therapy.
Why is CVS Health expanding its use of biosimilars?
"Our formulary plays a critical role in addressing rising drug costs without compromising clinical quality," said Joshua Fredell, PharmD, SVP, CVS Health. "Expanding adoption of FDA‑approved biosimilars allows us to deliver significant savings for clients while supporting broader, more affordable access to proven therapies."
How will these changes expand access to lower-cost, interchangeable biosimilars therapies?
In addition to changes involving Stelara, CVS Caremark is expanding biosimilar coverage across select specialty categories, including treatments for multiple sclerosis and rare blood disorders, such as biosimilar alternatives to therapies like Tysabri (with biosimilars Briumvi and Tyruko) and Soliris (biosimilar Epysqli®). These biosimilars meet the same FDA standards for safety, effectiveness, and quality as their reference products and, where applicable, are designated as interchangeable, offering a more affordable option for patients and plan sponsors.
These updates are part of CVS Caremark's broader formulary strategy, which prioritizes:
- Affordability: Leveraging competition to reduce net drug costs
- Access: Expanding availability of clinically appropriate treatment options
- Value: Supporting long-term sustainability for clients and members
What is a formulary and how does it impact patients?
A formulary is a list of prescription medications available under a health plan, managed with the support of a pharmacy benefit manager. CVS Caremark regularly evaluates its template formularies — which plan sponsors may adopt or customize based on the needs of their populations — to help support member access to clinically appropriate treatments, as evaluated by an independent Pharmacy & Therapeutics committee, while helping manage overall drug costs for clients and the members they serve.
How is CVS Caremark supporting clients and members through these changes?
CVS Caremark will provide advanced communication and support to clients, consultants, providers and members to help ensure a smooth transition to preferred therapies. These efforts include proactive outreach, educational resources, and clinical support programs.
These formulary updates are one component of CVS Health's ongoing efforts to address rising prescription drug costs and improve access to affordable medications for the millions of Americans it serves.
