CommercialCoverageHigh impact
Chronic Plaque Psoriasis
Blue Cross & Blue Shield of Mississippi·MS · Dermatology, Rheumatology·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
BCBSMS updated their chronic plaque psoriasis policy with significant formulary changes. Hadlima and Simlandi become the only covered adalimumab options effective 01/01/2025, while Selarsdi, Steqeyma, and Yesintek become the only covered ustekinumab options effective 08/01/2025. Multiple previously covered medications including Humira, Stelara, and others are no longer covered.
Action Required
Immediately: Update prior authorization protocols to reflect new formulary restrictions. By January 1, 2025: Only submit prior auth requests for Hadlima and Simlandi for adalimumab prescriptions - all other adalimumab products (including Humira) are not covered. By August 1, 2025: Only submit prior auth requests for Selarsdi, Steqeyma, and Yesintek for ustekinumab prescriptions - Stelara and other ustekinumab products will not be covered. Update EMR alerts to notify providers of formulary restrictions to prevent denied claims.