Medicare AdvantagePrior AuthMedium impact
Ebglyss™ (lebrikizumab-lbkx) subcutaneous (Revised)
Humana·Dermatology, Allergy & Immunology, Pediatrics·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Ebglyss™ (lebrikizumab-lbkx) subcutaneous injections for atopic dermatitis treatment. Patients must meet specific criteria including age/weight requirements, failed topical treatments, and failed Dupixent therapy before approval.
Action Required
Before January 1, 2026: Billing team must update prior authorization workflows for Ebglyss™ (lebrikizumab-lbkx) subcutaneous injections. Providers must verify patients meet all 4 criteria: moderate-to-severe atopic dermatitis diagnosis, age 12+ and weight 40kg+, failed high-potency topical corticosteroid or calcineurin inhibitor, and failed Dupixent therapy. Visit www.humana.com/PAL for medical billing codes and preauthorization requirements. Claims will be denied without proper prior authorization.