Medicare AdvantagePrior AuthMedium impact
Akynzeo (fosnetupitant-palonosetron/netupitant- palonosetron)
Humana·Oncology, Hematology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage is implementing new prior authorization requirements for Akynzeo (anti-nausea medication used with chemotherapy) effective January 1, 2026. Oral capsules require failure, contraindication, or side effects with aprepitant first, while both oral and IV forms must be used with highly or moderately emetogenic cancer chemotherapy.
Action Required
By January 1, 2026: Billing team must update prior authorization protocols for Akynzeo (fosnetupitant-palonosetron/netupitant-palonosetron) prescriptions. Ensure providers document aprepitant failure/contraindication/side effects for oral capsules and confirm use with highly or moderately emetogenic chemotherapy for all formulations. Update encounter forms to include these documentation requirements. Claims will require prior authorization approval before dispensing.