Medicare AdvantagePrior AuthMedium impact
Bupropion Containing Products (Aplenzin®, Forfivo XL®) (Revised)
Humana·Psychiatry, Family Medicine, Internal Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
New step therapy requirements for brand-name bupropion products (Aplenzin, Forfivo XL) under Medicare Advantage plans. Patients must first try generic bupropion plus another antidepressant before brand coverage will be approved.
Action Required
Before January 1, 2026: Providers prescribing Aplenzin or Forfivo XL must document prior therapy with generic bupropion AND an SSRI, SNRI, or mirtazapine to meet step therapy requirements. Update EMR templates to include required documentation for prior authorization approval.