Specialty medical injectable drug program updates: Moving to biosimilars for Rituxan

Biosimilars create a more competitive pricing environment among drug manufacturers that can help drive down drug costs, and the continued development of new biosimilar medications is a key factor in long-term specialty cost management. UnitedHealthcare strives to provide coverage for biosimilars whenever possible to ensure a robust pipeline of future products. Each innovator (original biologic) and its biosimilar are evaluated one by one and when financially supportable, we prefer the biosimilar.

Effective Oct. 1, 2020, Rituxan®, the innovator brand, will no longer be preferred for individuals new to therapy. Members will need to have tried both RuxienceTM and Truxima® (the biosimilars), prior to the use of Rituxan. The same preferred products will be required for Rituxan Hycela.

These updates apply to oncology and non-oncology use. UnitedHealthcare will honor all approved prior authorizations on file until the end date on the authorization or the date the member’s eligibility changes. 

Updates to specialty medical injectable drugs
Innovator Brand Biosimilar Brand(s) Administration method Benefit Preferred
Product 10/1
Rituxan

Ruxience

Truxima

Physician administered Medical

Ruxience

Truxima

Footnotes

Note: Certain specialty medical injectable drug program updates will not be implemented for providers practicing in Rhode Island until reviewed and approved by the Rhode Island Office of Health Insurance Commissioner (OHIC).

Please email UHC Medical Specialty mailbox with questions.