Effective 1 de janeiro, 2023, BCBSRI will cover the infliximab biosimilar products, Avsola and Inflectra, in place of Remicade. If you currently have patients with an authorization for Remicade, you and the member will receive a letter regarding this change. You will need to speak with your patients about switching to Avsola or Inflectra, prior to 1 de janeiro, 2023.

If you believe it is medically necessary for your patient to continue on Remicade after 1 de janeiro, 2023, you will need to complete a coverage exception form and submit it to Prime Therapeutics beginning 1 de janeiro, 2023.

Please note BCBSRI did not end date any Medicare authorizations for Remicade that are currently active. The change for Remicade for Medicare members will apply to new starts only effective 1/1/23. 

If you have any additional questions, or would like more information pertaining to letters sent, please contact providerrelations@bcbsri.org.