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Pharmacy Medical Policy Updates

The following Pharmacy Medical Policy programs have been updated June 1, 2026 and will take effect on July 1, 2026:

Prescription Drug Policies

  • Acute Migraine Agents
  • Biologic Immunomodulators
  • Cannabidiol
  • Cardamyst PA program approved by email
  • Cardiac Myosin Inhibitors (formerly Camzyos)
  • Cibinqo
  • Epinephrine
  • Fintepla
  • High Cost
  • IL-1 Inhibitors
  • IL-4 Inhibitors
  • Lupus
  • Northera
  • Otezla
  • CGM
  • Samsca 

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

  • Adzynma
  • Akynzeo_IV
  • Aldurazyme
  • Alpha-1_PI
  • Bavencio
  • Cosentyx
  • Elaprase
  • Elelyso
  • Elfabrio
  • Fabrazyme
  • Imfinzi
  • Imjudo
  • Jemperli
  • Kanuma
  • Lamzede
  • Lenmeldy
  • Libtayo
  • Loargys
  • Loqtorzi
  • Lumizyme
  • Mepsevii
  • Naglazyme
  • Nexviazyme
  • Penpulimab-KCQX
  • Pombiliti
  • Poteligeo
  • Reblozyl
  • Revcovi
  • Rituximab_IV
  • Rituximab_SQ  
  • Romidepsin
  • Tecentriq_IV
  • Tevimbra
  • Unloxcyt
  • Vimizim
  • VPRIV
  • Xenpozyme
  • 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.