Medicare AdvantagePrior AuthLow impact
Sofdra (sofpironium) (New)
Humana·Dermatology, Family Medicine, Internal Medicine·Medicare Advantage
Effective date
Jan 28, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Sofdra (sofpironium) topical gel, a new medication for treating excessive underarm sweating. Patients must meet specific criteria including 6+ months of symptoms, severe hyperhidrosis rating, and previous treatment failure with conventional therapies.
Action Required
By January 28, 2026: Billing team must update prior authorization workflows for Sofdra (sofpironium) prescriptions for Medicare Advantage patients. Providers must document: 1) Primary axillary hyperhidrosis diagnosis for 6+ months, 2) HDSS severity score of 3 or 4, and 3) previous treatment failure with aluminum chloride antiperspirants or oral oxybutynin. Visit www.humana.com/PAL for medical billing request procedures.