CVS Shifts to Biosimilars With $0 Member Cost, Expands Tysabri and Soliris Coverages
CVS•Effective July 1, 2026, CVS Caremark will shift reference biologics such as Stelara to interchangeable biosimilars Pyzchiva and Yesintek at $0 out-of-pocket for most members. The formulary update also expands biosimilar coverage for therapies like Tysabri (Briumvi and Tyruko) and Soliris (Epysqli) to reduce net drug costs and improve access.
1. Formulary Updates Effective July 1, 2026
CVS Caremark will implement targeted changes to its most common commercial template formularies on July 1, 2026, to prefer FDA-approved interchangeable biosimilars over select reference brands. This includes transitioning Stelara (ustekinumab) to lower-cost biosimilars Pyzchiva and Yesintek.
2. Member Cost Impact and Client Savings
Under the updated formulary, most members will incur $0 out-of-pocket costs for preferred biosimilar therapies, while clients benefit from reduced net drug costs. CVS projects significant savings outcomes by leveraging biosimilar competition without compromising clinical standards.
3. Expansion Across Specialty Categories
Beyond ustekinumab, CVS Caremark is broadening biosimilar adoption in specialty areas, covering multiple sclerosis and rare blood disorder treatments. Preferred alternatives include Briumvi and Tyruko for Tysabri, and Epysqli for Soliris, all meeting FDA safety, effectiveness, and interchangeability criteria.
