Pharmacy Medical Policy Updates
Prescription Drug Policies
The following Pharmacy Medical Policy programs were updated Sept. 1, 2026 and will take effect on Oct. 1, 2026, unless otherwise noted:
- Biologic Immunomodulators
- Cibinqo
- DPP4
- High Cost Agents
- IL-13
- IL-31
- IL-4
- Imcivree
- Leucovorin
- Lupus
- Oral Anticoagulants
- Otezla
- Rhapsido
- SA Oncology
- VMAT2 Inhibitors
- Weight Loss Agents
- Nereus (effective Nov. 1, 2026)
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 were updated Sept. 1, 2026 and will take effect on Oct. 1, 2026, unless otherwise noted:
- Amvuttra
- Bavencio
- Cinqair
- Datroway
- Decnupaz
- Denosumab
- Evenity
- Exdensur
- Fasenra
- GCSF_SA
- Golimumab_IV
- Hympavzi
- Imfinzi
- Imjudo
- Jemperli
- Krystexxa
- Levoleucovorin
- Libtayo
- Loqtorzi
- Nucala
- Onpattro
- Opdualag
- Penpulimab-KCQX
- Qalsody
- Rituximab_IV
- Sustol
- Tecentriq_IV
- Tecentriq_SQ
- Tecvayli
- Tevimbra
- Tezspire
- Unloxcyt
- Vyepti
- Vyvgart_IV
- Vyvgart_SQ
- Xolair
- Zynyz
- Leuprolide_depot
- Supprelin_LA
- Trelstar
- Triptodur
- Zoladex
- Zoledronic_Acid
- Fosaprepitant IV (effective Nov. 1, 2026)
- Fulvestrant (effective Nov. 1, 2026)
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.