Date: September 17, 2025
Attention: All Providers
Effective date: July 28, 2025
Call to action: Texas Children’s Health Plan (TCHP) would like inform providers that effective July 28, 2025 the Texas Health and Human Services Commission (HHSC) has updated the Texas Medicaid Preferred Drug List (PDL) for adalimumab (Humira) products.
In addition to the reference product Humira, five FDA approved biosimilars are now available as preferred medications on the Texas Medicaid PDL: adalimumab-ADAZ, adalimumab-FKJP, Hadlima (adalimumab BWWD), HULIO (adalimumba FKJP), and Simlandi (adalimumab-RYVK). All other biosimilar products for Humira are non-preferred and will require PDL prior authorization.
Preferred PDL products are available at a considerable cost savings compared to non-preferred PDL products, reflecting HHSC’s ongoing review of clinical evidence supporting biosimilar equivalence and cost-effectiveness.
| Texas Medicaid PDL Preferred | Texas Medicaid PDL Non-Preferred |
Adalimumab-ADAZ adalimumab-FKJP HADLIMA (adalimumab BWWD) HULIO (adalimumba FKJP)
SIMLANDI (adalimumab-RYVK) HUMIRA (adalimumab) | adalimumab-ADBM AMJEVITA (adalimumab-ATTO) CYLTEZO (adalimumab-ADBM) HYRIMOZ (adalimumab-ADAZ) |
As healthcare expenditures rise, biosimilar drugs represent a clear opportunity to reduce healthcare costs while maintaining patient access to treatment options for patients. To support this goal, we encourage providers to consider transitioning patients currently prescribed non-preferred PDL products to one of the following preferred alternatives, when clinically appropriate and in the best interest of the patient: adalimumab–ADAZ, adalimumab-FKJP, Hadlima (adalimumab-BWWD), Hulio (adalimumab-FKJP), Simlandi (adalimumab-RYVK), or Humira (adalimumab). This can be accomplished by either writing a new prescription with a DAW-1 (Dispense-As-Written) notation. Providers are not required to complete a new prior authorization unless the previous prior authorization for a non-preferred PDL product has expired.
Next steps: Providers should share this communication with their staff.
If you have any questions, please email TCHP Pharmacy at:tchppharmacy@texaschildrens.org.
For access to all provider alerts,log into:
www.texaschildrenshealthplan.org/provideralerts.