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CVS Caremark Expands Biosimilar Adoption Through Formulary Updates to Improve Affordability and Access

Key Takeaway: CVS Health announced updates to its commercial formularies to enhance the adoption of lower-cost biosimilars, effective July 1, 2026. The changes will prefer interchangeable biosimilars over select reference brands, aiming to reduce drug costs while maintaining clinical quality. This initiative is part of CVS's broader strategy to improve affordability and access to medications for its members.

Market Sentiment Analysis

POSITIVE FACTORS

  • Significant client savings expected from formulary updates.
  • Increased access to lower-cost, interchangeable biosimilars.
  • Support for broader access to proven therapies.
  • No out-of-pocket costs for most members for certain therapies.

Full Press Release Details

New changes expected to deliver significant client savings while maintaining rigorous clinical standards
WOONSOCKET, R.I.,May 5, 2026/PRNewswire/ -- CVS Health (NYSE:CVS) today announced updates to its most common commercial template formularies that will expand the use of lower-cost biosimilars across multiple therapeutic categories, including changes effective July 1, 2026, that will prefer interchangeable biosimilars over select reference brands.

What changes are CVS Caremark making to its formulary?

Effective July 1, 2026, CVS Caremark® will implement targeted updates to its most common commercial template formularies to increase adoption of U.S. Food and Drug Administration (FDA)-approved biosimilars with no clinically meaningful differences from the reference product and, in many cases, designated as interchangeable.
As part of these updates, CVS Caremark will transition from Stelara® (ustekinumab) on its most common commercial template formularies to preferring lower-cost, interchangeable biosimilar alternatives— Pyzchiva® and Yesintek®. With this change, most members will pay $0 out-of-pocket for their therapy.

Why is CVS Health expanding its use of biosimilars?

"Our formulary plays a critical role in addressing rising drug costs without compromising clinical quality," said Joshua Fredell, PharmD, SVP, CVS Health. "Expanding adoption of FDA‑approved biosimilars allows us to deliver significant savings for clients while supporting broader, more affordable access to proven therapies."

How will these changes expand access to lower-cost, interchangeable biosimilars therapies?

In addition to changes involving Stelara, CVS Caremark is expanding biosimilar coverage across select specialty categories, including treatments for multiple sclerosis and rare blood disorders, such as biosimilar alternatives to therapies like Tysabri® (with biosimilars Briumvi® and Tyruko®) and Soliris® (biosimilar Epysqli®). These biosimilars meet the same FDA standards for safety, effectiveness, and quality as their reference products and, where applicable, are designated as interchangeable, offering a more affordable option for patients and plan sponsors.
These updates are part of CVS Caremark's broader formulary strategy, which prioritizes:
• Affordability:Leveraging competition to reduce net drug costs
• Access:Expanding availability of clinically appropriate treatment options
• Value:Supporting long-term sustainability for clients and members

What is a formulary and how does it impact patients?

A formulary is a list of prescription medications available under a health plan, managed with the support of a pharmacy benefit manager. CVS Caremark regularly evaluates its template formularies — which plan sponsors may adopt or customize based on the needs of their populations — to help support member access to clinically appropriate treatments, as evaluated by an independent Pharmacy & Therapeutics committee, while helping manage overall drug costs for clients and the members they serve.

How is CVS Caremark supporting clients and members through these changes?

CVS Caremark will provide advanced communication and support to clients, consultants, providers and members to help ensure a smooth transition to preferred therapies. These efforts include proactive outreach, educational resources, and clinical support programs.
These formulary updates are one component of CVS Health's ongoing efforts to address rising prescription drug costs and improve access to affordable medications for the millions of Americans it serves.
About CVS HealthCVS Healthis a leading health solutions company building a world of health around every consumer, wherever they are. As of December 31, 2025, the Company had approximately 9,000 retail pharmacy locations, more than 1,000 walk-in and primary care medical clinics and a leading pharmacy benefits manager with approximately 87 million plan members. The Company also serves an estimated more than 37 million people through traditional, voluntary and consumer-directed health insurance products and related services, including highly rated Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan. The Company's integrated model uses personalized, technology driven services to connect people to simply better health, increasing access to quality care, delivering better outcomes, and lowering overall costs.

Media Contact:Phil Blando[email protected]

SOURCE CVS Health

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Frequently Asked Questions

What changes are CVS Caremark making to its formulary?

CVS Caremark will prefer lower-cost, interchangeable biosimilars over select reference brands starting July 1, 2026.

Why is CVS expanding its use of biosimilars?

CVS aims to reduce drug costs while ensuring clinical quality and improving access to therapies.

How will these changes affect patient costs?

Most members will pay $0 out-of-pocket for therapies like Stelara due to the formulary updates.

What is a formulary?

A formulary is a list of medications available under a health plan, managed by a pharmacy benefit manager.

How is CVS supporting clients through these changes?

CVS will provide communication, educational resources, and clinical support to ensure a smooth transition.

Last updated: May 5, 2026