Traditional MedicarePrior AuthLow impact
Unloxcyt™ (cosibelimab-ipdl) (New)
Humana·KY, SC, VA · Oncology, Dermatology·Medicaid
Effective date
Feb 25, 2026
We identified it
Jun 24, 2026
Summary
New prior authorization policy for Unloxcyt (cosibelimab-ipdl), a cancer immunotherapy drug for advanced cutaneous squamous cell carcinoma. Requires prior auth for Medicare and Medicaid members in Kentucky, South Carolina, and Virginia starting February 25, 2026.
Action Required
Before February 25, 2026: Billing team must update prior authorization system to require approval for Unloxcyt (cosibelimab-ipdl) infusions for Medicare and Medicaid members in Kentucky, South Carolina, and Virginia. Ensure providers understand the four criteria requirements: locally advanced/metastatic cutaneous squamous cell carcinoma, not candidate for curative surgery/radiation, monotherapy use only, and no prior PD-1/PD-L1 inhibitor progression. Initial approval duration is 6 months.