Traditional MedicarePrior AuthMedium impact
Exdensur™ (depemokimab-ulaa) (Revised)
Humana·KY, SC, VA · Pulmonology, Allergy & Immunology, Internal Medicine +1 more·Medicaid
Effective date
Mar 25, 2026
We identified it
Jun 24, 2026
Summary
Humana has revised its prior authorization policy for Exdensur™ (depemokimab-ulaa), a new subcutaneous injection for severe asthma with eosinophilic phenotype. The policy establishes specific criteria for coverage including diagnosis requirements, eosinophil level thresholds, and different step therapy requirements for Medicare Part D, Medicare Part B, and Medicaid requests.
Action Required
Before March 25, 2026: Billing team must update prior authorization systems to include Exdensur™ (depemokimab-ulaa) subcutaneous injection requirements. Providers must document severe asthma diagnosis, eosinophil levels (≥150 cells/μL at initiation or ≥300 cells/μL in past 12 months), and evidence of inadequate control on maximum tolerated inhaled corticosteroids plus long-acting beta agonist. For Medicare Part B requests, document trial or inability to use Nucala AND Fasenra. Update encounter forms and EMR templates to capture required documentation elements.