Medicare AdvantagePrior AuthMedium impact
Akeega (niraparib and abiraterone acetate) (Revised)
Humana·Oncology, Urology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has established a new prior authorization policy for Akeega (niraparib and abiraterone acetate) effective January 1, 2026, for Medicare Advantage members with metastatic prostate cancer. The policy requires documented BRCA mutations and specific combination therapies for coverage approval.
Action Required
By January 1, 2026: Billing team must ensure prior authorization is obtained for all Akeega prescriptions for Medicare Advantage members. Verify patients have documented BRCA mutations, metastatic prostate cancer diagnosis, and will use medication in combination with prednisone/prednisolone and androgen deprivation therapy. Update system to flag patients with prior PARP inhibitor therapy as this excludes coverage approval.