Preferred adalimumab biosimilar (Simlandi)
Specifies Blue Cross Blue Shield of Michigan/Blue Care Network commercial members' preferred adalimumab product (Simlandi) and describes prior authorization submission requirements and rejected products that will delay therapy.
Simlandi is designated as the preferred adalimumab product for most Blue Cross Blue Shield of Michigan and Blue Care Network commercial members.
Selecting specified non-preferred adalimumab products (adalimumab-ryvk NDCs) when submitting a prior authorization will result in the authorization being rejected and may delay therapy.
Adalimumab Product Preference
Adalimumab product preference and prior authorization
Preferred product requirement and prior authorization submission guidance for commercial members:
Prior authorization submission requirement
- When submitting a prior authorization request for an adalimumab product, select one of the preferred Simlandi products: Simlandi kit 40/0.4 mL (NDC 51759-0412-22); Simlandi 1 pen kit 40/0.4 mL (NDC 51759-0402-17); Simlandi 2 pen injection 40/0.4 mL (NDC 51759-0402-02).
Products that will cause PA rejection
- If any of the listed adalimumab-ryvk products are selected when submitting a prior authorization, the authorization will be rejected and may delay the member's therapy: Adalimumab-ryvk 40 mg syringe (NDC 82009-0158-22); Adalimumab-ryvk 2 pens (NDC 82009-0156-22).
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