CommercialPrior AuthLow impact
Voydeya (danicopan)
Blue Cross & Blue Shield of Mississippi·MS · Hematology, Oncology·Medical Policy
Effective date
Mar 31, 2025
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has added a new policy for Voydeya (danicopan), a complement inhibitor used as add-on therapy for paroxysmal nocturnal hemoglobinuria (PNH). Prior authorization is required for all patients, with strict criteria including confirmed PNH diagnosis, concurrent use with eculizumab or ravulizumab, and specialist involvement.
Action Required
By March 31, 2025: Billing team must update prior authorization systems to require pre-approval for Voydeya (danicopan) prescriptions. Ensure hematology/oncology specialists are aware of the detailed criteria including PNH diagnosis confirmation, hemoglobin ≤9.5 g/dL, reticulocyte count ≥120 x 10^9/L, and mandatory concurrent use with eculizumab or ravulizumab. Claims without prior authorization will be denied.