Pharmacy Information and Preferred Drug List Changes - Additional Third Quarter 2023 Coverage Updates

Date: 08/30/23

Change to Adalimumab Preferred Products

As health care expenditures rise, biosimilar drugs represent a clear opportunity to reduce healthcare costs while maintaining patient access to vital therapies. Described by the US Food and Drug Administration (FDA), a biosimilar is a “biological product that is highly similar to the reference product notwithstanding mirror differences in clinical inactive components.” “There are no clinically meaningful differences between the biological product and the reference product in terms of the safety, purity, and potency of the product."^1,2 We constantly innovate and deliver personal, caring service for our members.

Effective 10.1.2023 Trillium is making a change to their preferred adalimumab products. The reference product, Humira, will no longer be preferred for members initiating treatment; current members being treated with Humira will be able to continue treatment with the reference product. View the Pharmacy Information and Preferred Durg List Changes - Additional Third Quarter 2023 Coverage Updates notice (PDF) for the list of preferred adalimumab biosimilars and formulations.

Trillium Community Health Plan Preferred Drug List Changes

Trillium’s Preferred Drug List (PDL) is updated monthly and is available online. View the Pharmacy Information and Preferred Durg List Changes - Additional Third Quarter 2023 Coverage Updates notice (PDF) for a summary of recent PDL changes. For the most current preferred drug list, visit the Pharmacy section of our website.

Prior Authorization Changes to Specialized Medications Given in Office

View the Pharmacy Information and Preferred Durg List Changes - Additional Third Quarter 2023 Coverage Updates notice (PDF) for all HCPC codes. These codes now require prior authorization for coverage for Trillium Oregon Health Plan members.

Additional Information

For additional information regarding changes to the Trillium Preferred Drug List (PDL), contact Trillium by telephone at 1-877-600-5472. For the most current version of the PDL, visit the Pharmacy section of the Trillium website.

For additional information on medication coverage guidelines, visit the Provider Resources section of Trillium’s website.

If you have questions regarding the information contained in this update, contact Trillium Provider Services through the Provider Resources section of Trillium’s website or by telephone at 1-877-600-5472.

1 Daller J. Biosimilars: A consideration of the regulations in the United States and European Union. Regulatory Toxicology and Pharmacology. 2016 Apr;76:199-208. Doi: 10.1016/jyrtph.2015.12.013.

2 US Food and Drug Administration. Review and Approval. URL: https://www.fda.gov/drugs/biosimilars/review-and-approval.