Pharmacy Medical Policy Updates
Prescription Drug Policies
The following Pharmacy Medical Policy programs will be updated Nov. 1, 2026 and will take effect on Dec. 1, 2026, unless otherwise noted:
- Agamree Emflaza
- APRIL Inhibitors, Fabhalta, Filspari, Vanrafia (formerly Fabhalta, Filspari, Vanrafia, Voyxact)
- Androgens and Anabolic Steroids
- Bempedoic Acid
- Carbaglu
- Crenessity
- Elagolix/Relugolix
- Fintepla
- Interleukin-4 (IL-4) Inhibitor
- Interleukin-13 (IL-13) Antagonist
- Recorlev
- Resistant Hypertension Agents
- SA Oncology
- Strensiq
- Urea Cycle Disorders
- Vasomotor Symptoms
- Voydeya
- Winlevi
- Xphozah
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 Nov. 1, 2026 and will take effect on Dec. 1, 2026, unless otherwise noted:
- Avlayah
- Bendamustine
- Beovu
- Bevacizumab_ONCO
- Cyramza
- Denosumab
- Elahere
- Encelto
- Factor VIII_vWF
- Halaven
- Imlygic
- Infliximab
- Kyxata
- Lumvoa
- Lytenava
- Omalizumab
- Paclitaxel Albumin-Bound
- Ranibizumab
- Retorpyk
- Rytelo
- Sarclisa_IV
- Susvimo
- Syfovre
- Trastuzumab_IV
- Tregzi
- Vabysmo
- Vyloy
- Zaltrap
- Zepzelca
- Botox
- Daxxify
- Dysport
- Myobloc
- Xeomin
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.