Committee approves medical drug recommendations, covers biosimilars for infusion and pharmacy sides

The Joint Budget Committee reviewed and approved medical drug recommendations that govern medications administered in clinical settings, including several biosimilars tied to the Stelara treatment pathway.

Grant Wallace, director of the Employee Benefits Division, said the first four entries on the medical list were biosimilars to Stelara, noting that the treatment typically begins with an IV infusion billed on the medical side before switching to pharmacy coverage. “When you look at the Stelara, they start on the medical side with an IV infusion and then switch over to the pharmacy,” Wallace said. He added the committee wants to ensure both sides are covered.

Wallace said the remainder of the list reflected routine reviews or exclusions of new-to-market drugs. The committee chair announced no questions were raised and that the item was “without objection, reviewed and approved.”