Pharmacy Medical Policy Updates
The following Pharmacy Medical Policy programs have been updated on March 1, 2026 and will take effect on April 1, 2026:
Prescription Drug Policies
- ADHD
- Biologic Immunomodulators
- CGM
- Fabhalta
- Filspari
- Filspari, Vanrafia, Fabhalta
- GLP-1 Agonists
- High Cost
- IL-4
- Journavx
- Kerendia
- Leucovorin
- Long-Acting Insulin
- Pseudobulbar Affect
- Rapid to Intermediate Acting Insulin
- Resmetirom
- SA Oncology
- Somatostatin Analogs
- Tarpeyo
- Weight Loss
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
- Adakveo
- Aflibercept
- Bavencio
- Breyanzi
- Danyelza
- Gemcitabine
- Givlaari
- Imdelltra
- Imfinzi
- Imjudo
- Jemperli
- Libtayo
- Loqtorzi
- Lunsumio
- Omisirge
- Penpulimab-KCQX
- Polivy
- Rituximab_IV
- Rituximab_SQ
- Spinraza
- Tecentriq_IV
- Tecentriq_SQ
- Tevimbra
- Unloxcyt
- 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.