Pharmacy Medical Policy Updates
Prescription Drug Policies
The following Pharmacy Medical Policy programs will be updated Aug. 1, 2026 and will take effect on Sept. 1, 2026:
- Antiretroviral
- Bempedoic Acid
- Cardiac Myosin Inhibitors
- Dry Eye Disease
- FCS
- PCSK9 Inhibitors
- Phosphate Binders
- Resistant Hypertension Agents (previously Tryvio)
- Resmetirom
- Vascepa
- Weight Management
The following Pharmacy Medical Policy programs will be updated and effective on Aug. 1, 2026:
- Oxybate
- Wakix
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
The following Pharmacy Medical Policy programs will be updated Aug. 1, 2026 and will take effect on Sept. 1, 2026:
- Alhemo
- Anti-Inhibitor_Ab
- Factor IX
- Factor VIIa
- Factor VIII
- Factor VIII_vWF
- Factor X
- Factor XIII
- Factor XIIIA_subunit
- Hympavzi
- Qfitlia
- Spevigo_SQ
- VWF
- Anti-Inhibitor Coagulant Complex
- Bevacizumab_ONCO
- Bizengri
- Crysvita
- Dextenza*
- Docetaxel
- Enhertu
- Iluvien*
- Kadcyla
- Margenza
- Ocrevus_IV
- Ozurdex*
- Paclitaxel Albumin-Bound
- Pemetrexed*
- Perjeta
- Phesgo
- Portrazza*
- Ranibizumab
- Retisert*
- Spevigo_IV
- Trabectedin
- Trastuzumab_IV
- Trastuzumab_SQ
- WAINUA
- Yutiq*
- Ziihera
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.