J1144 Insurance Policy Changes

Xgeva® (denosumab) and biosimiliars (Revised)

Humana revised its Xgeva (denosumab) and biosimilar coverage policy effective January 1, 2026, with a revision date of July 1, 2026. The policy now covers nine denosumab products (Xgeva, Wyost, Osenvelt, Bomyntra, Bilprevda, Xtrenbo, Aukelso, Jubereq) for four oncology indications and requires prior authorization with specific clinical criteria including step therapy requirements (prior bisphosphonate failure for most indications). The policy distinguishes between preferred products (Xgeva and Xtrenbo) and non-preferred biosimilars, with Medicare Part B continuation-of-therapy exceptions.