CVS Health Enhances Biosimilar Utilization with Key Formulary Updates

CVS Health, a prominent name in healthcare solutions, is taking significant steps to address the soaring prescription drug costs affecting millions of Americans. On May 5, 2026, the company announced its intention to revise its main commercial template formularies, officially expanding the usage of affordable biosimilars within diverse therapeutic categories. These changes, set to take effect on July 1, 2026, encourage the preference of interchangeable biosimilars over certain established reference brands.

The Formulary Changes

CVS Caremark® will initiate targeted updates aimed at increasing the adoption of U.S. Food and Drug Administration (FDA)-approved biosimilars—products that demonstrate no clinically meaningful differences from their reference counterparts. In many instances, these biosimilars are designated as interchangeable, allowing for greater acceptance among healthcare providers and patients alike. The initial move will affect the transition from the established drug Stelara® (ustekinumab) to its more cost-effective biosimilar alternatives, Pyzchiva® and Yesintek®, making the therapy free for the majority of patients.

Joshua Fredell, PharmD and Senior Vice President of CVS Health, shared the company's motivation for expanding biosimilar adoption: “Our formulary plays a critical role in addressing rising drug costs without compromising clinical quality.” He emphasized that these updates provide considerable savings while ensuring patients have access to effective and safe therapies.

CVS Health has also indicated its commitment to cover additional biosimilars across various specialist categories. This includes alternatives for therapies used in multiple sclerosis and rare blood disorders, such as the biosimilars Briumvi® and Tyruko® for Tysabri® and Epysqli® as a replacement for Soliris®. These biosimilars have been confirmed to meet the FDA's rigorous standards regarding safety, efficacy, and quality, further reassuring patients about their therapeutic equivalence to brand-name drugs.

Understanding the Importance of Formulary Changes

For those unfamiliar with this term, a formulary is a list of prescription medications that a health plan covers, managed with the assistance of a pharmacy benefit manager. CVS Caremark regularly evaluates its formularies, which can be customized by plan sponsors to fit their population's specific needs. The goal is to enable access to clinically appropriate treatment options while effectively managing overall drug costs for clients.

Providing Support for a Smooth Transition

To ensure a smooth adaptation to these preferred therapies, CVS Caremark plans to implement proactive communications and supportive resources for clients, consultants, medical providers, and members. This initiative will involve educational materials and clinical support programs to ease the transition.

These formulary updates are a part of CVS Health's ongoing strategy to combat rising prescription costs and improve access to cost-effective health solutions.

Looking Ahead

As CVS Health continues to innovate and refine its healthcare delivery model, it signifies its focus on leveraging competition to drive down drug costs, enhance access to therapeutically appropriate options, and support the long-term sustainability of healthcare for its clients and members. The adjustments to the formulary are not merely administrative changes; they represent CVS Health's commitment to making healthcare more accessible and affordable for all Americans—a pledge that will resonate as the company strives to meet the needs of the community it serves.

About CVS Health

CVS Health operates as a leading health solutions provider dedicated to fostering a healthier future for consumers. The company boasts around 9,000 retail pharmacy locations and more than 1,000 walk-in clinics, along with a robust pharmacy benefits manager covering approximately 87 million plan members. Supported by a range of health insurance products and advanced technology-driven services, CVS Health connects individuals with quality care, aiming to enhance overall health outcomes while minimizing costs.