The biosimilars playbook: Helping you manage spend and trend
Biosimilars, at-a-glance
- FDA‑approved therapies that are interchangeable with the originally prescribed biologic therapy, in states where permitted
- Designed to increase competition and lower drug costs
- Used today across multiple specialty categories
- May cost members less, similar to traditional generics
Specialty drug costs continue to rise, particularly for biologic therapies. Biosimilars are widely used FDA‑approved therapies that have changed how specialty medications are accessed and paid for.
At CVS Caremark®, our biosimilar strategy helps you lower costs, expand access to effective therapies and support members through change — without compromising clinical standards.
Results that matter
We’ve been at the forefront — driving early biosimilar adoption and shaping strategies that are simple, smart and affordable.
The result?
Since removing Humira® from our commercial formulary in April, 2024, our biosimilar formulary strategy has helped more members switch to lower-cost alternatives, fueling adoption and savings.
A formulary decision that changed the market
We were the first PBM to remove Humira® from major commercial formularies and replace it with biosimilars.
The result?
More competition and lower costs across the market.
CVS Caremark drove more biosimilar prescriptions
in April 2024, than the entire industry in 2023.
As adoption expanded, the market followed — moving to lower‑cost, clinically appropriate alternatives. We’re now applying these proven strategies as we replace Stelara® with biosimilars in our commercial formularies.
The result?
Most members will pay $0
out-of-pocket for Stelara biosimilars.*
Cost shouldn’t stand in the way of care
Lower costs can make the difference between starting therapy and being able to continue it. By expanding access to more affordable biosimilars, we help members stay on track with their treatment, while helping clients manage specialty drug costs.
Expanding adoption of FDA‑approved biosimilars allows us to deliver savings for clients while supporting broader, more affordable access to proven therapies.
Joshua Fredell
PharmD, SVP, CVS Health
From strategy to savings: A better biosimilar experience
Using competition, negotiations and market insight to reduce overall spend
Innovative plan designs that help limit out-of-pocket surprises
Outreach that helps members and prescribers understand what they need to know
Formulary optionality (including low list price strategies) reduces reliance on rebates
As biosimilars enter the market, we evaluate them carefully: how well they work, their safety and quality, cost, supply and member impact. This consistent framework guides our decisions and helps us communicate clearly as changes happen.
See how biosimilars can transform your formulary strategy
Your members are at the heart of what we do
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*FOR 3.3B IN GROSS SAVINGS CLAIM: CVS Health Analytics, 2026. CVS Commercial clients Apr 2024 - Dec 2025. P1017640325
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*FOR 93% ADOPTION CLAIM: CVS Health Analytics, 2026. CVS Commercial clients Apr 2024 - Dec 2025.
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*FOR $0 OUT-OF-POCKET COST CLAIM: CVS Health Analytics, 2026. CVS Commercial clients. Approximately 88% of preferred biosimilar-utilizing members had an out-of-pocket cost of $0 from April 1, 2024 - December 31, 2025. P1017780525
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*FOR $0 OUT-OF-POCKET COST CLAIM FOR STELARA BIOSIMILARS: CVS Health Analytics, 2026.
All data sharing complies with applicable law, our information firewall and any applicable contractual limitations. Savings projections are based on CVS Caremark data. Actual results may vary depending on benefit plan design, member demographics, programs implemented by the plan and other factors.
This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Health.