Medicare AdvantagePrior AuthMedium impact
Cosentyx (secukinumab) subcutaneous solution (Revised)
Humana·Rheumatology, Dermatology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has updated prior authorization requirements for Cosentyx (secukinumab) effective January 1, 2026. The policy requires patients to fail at least two specific preferred treatments before approval, with different age requirements and failure criteria for each indication including psoriatic arthritis, plaque psoriasis, and ankylosing spondylitis.
Action Required
By January 1, 2026: Clinical and billing teams must update prior authorization protocols for Cosentyx prescriptions for Medicare Advantage patients. Ensure documentation shows failure of at least two preferred treatments (adalimumab products, Enbrel, Skyrizi, Rinvoq, Stelara, Otulfi, Yesintek, or Tremfya) based on the specific indication and age requirements. Update EMR templates to capture required prior therapy history. Claims without proper prior authorization will be denied.