Excellus BlueCross BlueShield expands its list of covered biosimilar medications, improving access and affordability

A stark increase in the use and cost of specialty medications is challenging health insurers’ affordability efforts nationwide. If this issue is left unaddressed, specialty medications would account for more than half of all drug spending at Excellus BlueCross BlueShield (Excellus BCBS) in 2026. 

To tackle this problem, Excellus BCBS has added two more U.S. Food and Drug Administration (FDA)-approved biosimilar medications to its list of covered drugs for certain plans. Biosimilars are similar but not identical to a brand-name biologic medication and are lower-cost alternatives that are just as effective as their biologic counterparts. 

Yesintek and Selarsdi, which are offered as preferred biosimilars for the reference drug Stelara (ustekinumab), are now covered. Stelara is a blockbuster biologic drug that is indicated for certain autoimmune conditions such as psoriasis, psoriatic arthritis, ulcerative colitis and Crohn’s disease. 

“Biosimilars represent one of the biggest opportunities for delivering on our mission for our members,” says Mona Chitre, Pharm.D., chief pharmacy officer and president of pharmacy solutions at Excellus BCBS. “Not only are they safe, effective and FDA-approved, adding more biosimilars to the list of medications covered by our health plan gives members a choice, increasing our communities’ access to affordable medications.”

Battling rising health care costs: equally effective treatment with better access at a better price

Rising costs and growing demand for health care - especially for hospital services and prescription drugs – are impacting the ability for people to access high quality care at a price that is affordable as possible. 

According to Iqvia Institute’s most recent Global Medicine Report, specialty medicines (like biologics) will represent 43% of global spending in 2028 and more than 55% of total spending in leading developed markets. 

Biologics are often used to treat complex conditions such as cancer, multiple sclerosis, or autoimmune disorders. These drugs can alter the course of disease in a positive way for patients, but they also carry exceptionally high costs. 

Biosimilars are just as effective as their “biologic” counterparts and are available both in the medical and pharmacy drug space. While most conventional drugs are chemically synthesized, biologics are made from natural and living sources like animal and plant cells, and microorganisms such as bacteria or yeast. They are usually more complex than other drugs and often more complicated to purify, process, and manufacture. These medications are FDA approved to treat most of the same conditions as the biologic in their drug category and can cost as much as 90% less.

Excellus BCBS pioneers coverage of biosimilars in the United States

Excellus BlueCross BlueShield (BCBS) has advocated for the use of biosimilars since 2018, when it was the first standalone health insurer in the U.S. to offer a biosimilar in a major drug category. 

Today the health plan includes biosimilars in all drug categories in which they are available. 
 

Contact:
Kim Allen Kim.Allen@excellus.com