Q2189 Insurance Policy Changes

Pemetrexed Products (Revised)

Humana revised its Pemetrexed Products prior authorization policy effective September 24, 2025, affecting coverage for pemetrexed-based chemotherapy across multiple pemetrexed formulations (Alimta, Pemfexy, Pemrydi RTU, Axtle) for malignant pleural mesothelioma and non-squamous non-small cell lung cancer. The policy maintains prior authorization requirements and renal function exclusions (CrCl < 45 ml/min) but clarifies approved treatment combinations and adds new first-line pembrolizumab-combination therapy criteria for NSCLC patients without EGFR/ALK mutations.