Medicare AdvantagePrior AuthMedium impact
Cosentyx (secukinumab) subcutaneous solution (Revised)
Humana·Dermatology, Rheumatology, Pediatrics·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has established prior authorization requirements for Cosentyx (secukinumab) for six specific conditions including psoriatic arthritis, plaque psoriasis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, juvenile idiopathic arthritis, and hidradenitis suppurativa. Each indication has specific age requirements and prior therapy criteria that must be met for approval.
Action Required
By January 1, 2026: Billing team must implement prior authorization requirements for all Cosentyx (secukinumab) prescriptions for Humana Medicare Advantage patients. Update billing system to flag these cases and ensure providers document specific diagnosis criteria, patient age requirements, and prior therapy history before submitting claims. Failure to obtain prior authorization will result in claim denials.