Pharmacy Medical Policy Updates
The following Pharmacy Medical Policy programs were updated on Dec. 1, 2025 and will take effect on Jan. 1, 2026:
Prescription Drug Policies
- Biologic Immunomodulators
- Corticotropin
- GLP-1 Agonists
- Hereditary Angioedema
- Hyftor
- IL-4 Inhibitors
- Opzelura
- Oral Inhalers
- Otezla
- PCSK9
- Phosphate Binders
- PPI
- Resmetirom
- Retinoids
- SA Oncology
- Thrombopoeitin Receptor Antagonists, Tavalisse, and Wayrilz
- Weight Management
- Xphosah
- Zeposia
- Zoryve
To view prescription drug policies specific to a formulary or medication list, please select that formulary on the Prior Authorization page of our website.
Medical Pharmacy Solutions Program Policies
- Aflibercept
- Amtagvi
- Bavencio
- Dawnzera
- Emrelis
- Fyarro
- Imfinzi
- Imjudo
- Inlexzo
- IVIG
- Jemperli
- Kyxata
- Leqembi_IV
- Leqembi_SQ
- Libtayo
- Long-Acting Granulocyte Colony Stimulating Factors (LA-gCSF)
- Loqtorzi
- Opdivo_IV
- Opdivo_SQ
- Penpulimab-KCQX
- Rituximab
- SCIG
- Tecelra
- Tecentriq_IV
- Tevimbra
- Tivdak
- Trastuzumab_IV
- Unloxcyt
- Ustekinumab
- Veopoz
- VWF
- Yervoy
- Zilretta
- Zynyz
To access Medical Pharmacy Solutions policies, please visit the Medical Pharmacy Policies (GatewayPA) page.
For additional questions, please refer to the Prior Authorization section of our website or contact your BCBSKS provider relations representative.