Effective January 1, 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 January 1, 2023.

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