Your patients are struggling to fill their adalimumab — here's how to help

If your patients are reporting difficulty filling their adalimumab prescriptions, you're not alone. Despite robust manufacturing supply and more than 10 FDA-approved biosimilars on the market, the practical reality of getting adalimumab into patients' hands remains frustrating. Formulary changes, specialty pharmacy requirements, and prior authorization backlogs mean your clinical team often becomes the de facto troubleshooter for medication access.

This guide provides actionable steps your practice can take to minimize treatment interruptions and streamline the adalimumab access process for your patients.

Current availability

Adalimumab is not in a drug shortage as of 2026. The FDA and ASHP do not list any adalimumab supply disruptions. Brand-name Humira and at least 10 biosimilars are being manufactured and distributed:

• Interchangeable biosimilars: Amjevita, Cyltezo, Hadlima, Hyrimoz, Hulio, Simlandi, Yuflyma
• Additional biosimilars: Yusimry, Abrilada, Idacio

The issue isn't supply — it's access logistics. Different payers cover different products, specialty pharmacies may have variable stock, and the administrative burden of prior authorizations creates gaps in care.

Why patients can't find it

Understanding the common barriers helps your team develop solutions:

1. Formulary mismatches

Your patient's insurance may prefer a biosimilar that their pharmacy doesn't stock — or vice versa. Major PBMs like Express Scripts and CVS Caremark shifted preferred products in 2025, and ongoing formulary changes continue to disrupt established prescription patterns.

2. Specialty pharmacy channeling

Most commercial and Medicare plans mandate dispensing through designated specialty pharmacies. If a prescription is sent to a retail pharmacy, it may be rejected. Patients may not know which specialty pharmacy their plan uses.

3. Prior authorization gaps

PA approvals typically last 6-12 months. Patients changing jobs, aging into Medicare, or switching plans may lose authorization without realizing it until they try to refill. New prescriptions almost always require a fresh PA.

4. Patient confusion about biosimilars

Many patients remain anxious about switching from Humira to a biosimilar, particularly if the switch was payer-driven rather than clinician-initiated. This can lead to non-adherence or delayed refills as patients hesitate.

What providers can do: 5 practical steps

Step 1: Know your top payers' preferred adalimumab products

Work with your practice manager or billing team to maintain a current list of preferred adalimumab products for your most common insurance plans. This saves time when writing prescriptions and reduces PA rejections.

Key formulary trends in 2026:

• Express Scripts: Primarily Cyltezo and adalimumab-adbm (unbranded)
• CVS Caremark: Variable by plan; often Hyrimoz or Hadlima
• UnitedHealthcare/Optum: Mix of biosimilars; check specific plan
• Medicare Part D: Varies widely; many plans now prefer biosimilars over Humira

Step 2: Prescribe with access in mind

Consider these prescribing strategies:

• For new starts: Align with the patient's formulary-preferred biosimilar from day one to minimize delays
• For stable patients facing a payer-mandated switch: Discuss the change proactively, explain that interchangeable biosimilars are clinically equivalent, and document the conversation
• Consider writing "adalimumab" generically with "dispense as formulary preferred" to give the pharmacy flexibility

Step 3: Streamline prior authorizations

PA management is one of the biggest bottlenecks. Consider these approaches:

• Designate a staff member as your "PA specialist" for biologics
• Use electronic prior authorization (ePA) when available — it's faster than fax
• Submit PAs proactively before the current authorization expires
• Keep templated clinical documentation ready for common adalimumab indications

Step 4: Use Medfinder to help patients locate stock

Medfinder for providers lets your staff check real-time pharmacy availability when a patient reports access issues. Instead of telling a patient to "call around," your team can identify specific pharmacies with the needed product in stock and direct the patient accordingly.

Step 5: Connect patients with financial assistance

Cost barriers often masquerade as availability problems. A patient may say they "can't find" their medication when the real issue is they can't afford the copay. Proactively offer these resources:

• Commercially insured patients: Manufacturer copay cards (Humira Complete: as low as $5/month; biosimilar manufacturers offer similar programs)
• Uninsured patients: AbbVie Patient Assistance Foundation (free Humira), biosimilar manufacturer assistance programs
• Medicare patients: PAN Foundation, HealthWell Foundation, state pharmaceutical assistance programs

Point patients to: How to Save Money on Adalimumab in 2026

Alternative TNF inhibitors to consider

When adalimumab access proves persistently difficult for a patient, switching to a different TNF inhibitor may be appropriate. The four FDA-approved alternatives are:

• Etanercept (Enbrel): Subcutaneous, weekly. Covers RA, PsA, AS, psoriasis, JIA. Not for IBD.
• Infliximab (Remicade and biosimilars): IV infusion every 6-8 weeks. Covers RA, Crohn's, UC, PsA, AS, psoriasis. In-office administration gives you direct control over access.
• Certolizumab pegol (Cimzia): Subcutaneous, every 2-4 weeks. Covers Crohn's, RA, PsA, AS, psoriasis. Does not cross placenta — preferred in pregnancy.
• Golimumab (Simponi/Simponi Aria): Subcutaneous monthly or IV every 8 weeks. Covers RA, PsA, AS, UC. Not for Crohn's.

See also: Alternatives to Adalimumab If You Can't Fill Your Prescription

Workflow tips for your practice

Building efficient workflows around biologic medication access can reduce patient complaints and staff burden:

• Track PA expiration dates and initiate renewals 30 days in advance
• Maintain a biosimilar reference sheet mapping payers to preferred products (update quarterly)
• Create patient handouts explaining biosimilar switching in plain language
• Establish relationships with 2-3 specialty pharmacies that your top payers use
• Use Medfinder (medfinder.com/providers) as a staff tool for real-time availability checks
• Document everything: PA submissions, denials, appeals, and patient communication about product switches

Final thoughts

Adalimumab access in 2026 is a solvable problem, but it requires intentional practice-level systems. The medication is available — the challenge is connecting patients to the right product through the right channel. By staying current on formulary preferences, proactively managing PAs, educating patients about biosimilars, and leveraging tools like Medfinder, your practice can significantly reduce treatment interruptions.

For additional provider resources, see our companion article: Adalimumab Shortage: What Providers and Prescribers Need to Know in 2026. For provider guidance on cost assistance, see How to Help Patients Save Money on Adalimumab.