MedicaidPrior AuthMedium impact
Padcev (enfortumab vedotin-ejfv) (New)
Humana·IN · Oncology, Urology·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana now requires prior authorization for Padcev (enfortumab vedotin-ejfv), a new cancer drug for advanced bladder cancer, effective February 1, 2026. The policy establishes specific clinical criteria including prior treatment requirements and combination therapy options.
Action Required
Before February 1, 2026: Billing team must update prior authorization system to require approval for Padcev (enfortumab vedotin-ejfv) for Indiana Medicaid patients with bladder cancer. Providers must verify patients meet specific criteria including prior platinum-containing chemotherapy and PD-1/PD-L1 inhibitor treatment, or cisplatin ineligibility with prior therapy, or combination use with Keytruda. Claims will be denied without proper prior authorization.