Pharmacy Medical Policy Updates
The following Pharmacy Medical Policy programs have been updated on April 1, 2026 and will take effect on May 1, 2026:
Prescription Drug Policies
- Amifampridine
- Arikayce
- Daybue
- Elmiron
- Fabhalta, Filspari, Vanrafia, Voyxact
- Familial Chylomicronemia Syndrome (formerly
- Tryngolza)
- Hyperhidrosis
- Interstitial Lung Disease
- PCSK9
- Subcutaneous Furosemide
- TPO-RA, Tavalisse, and Wayrilz
- Urea Cycle Disorders
- Urinary Incontinence Agents
- VMAT2 Inhibitors
- Vykat XR
- Weight Management
- Xdemvy
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
- Adcetris
- Adstiladrin
- Anktiva
- Aranesp
- Cerezyme
- Cosentyx
- Darzalex_IV
- Datroway
- Enhertu
- Epoetin_alfa
- Erbitux
- Ilaris
- Inlexzo
- Jelmyto
- Keytruda_IV
- Keytruda_SQ
- Lunsumio_IV
- Lunsumio_SQ
- Nplate
- Onivyde
- Opdivo_IV
- Opdivo_SQ
- Oxlumo
- Padcev
- Perjeta
- Rivfloza
- Rybrevant_IV
- Rybrevant_SQ
- Trodelvy
- Uplizna
- Yartemlea
- Yervoy
- Zusduri
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.