Medicare AdvantagePrior AuthMedium impact
Firmagon (degarelix) (Revised)
Humana·Oncology, Urology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Firmagon (degarelix) injections used to treat advanced prostate cancer. The policy requires diagnosis of advanced prostate cancer or high risk of disease recurrence, and excludes concomitant use with other LHRH analogs.
Action Required
By January 1, 2026: Billing team must obtain prior authorization from Humana before administering Firmagon (degarelix) for Medicare Advantage patients with prostate cancer. Verify patient has advanced prostate cancer or high disease recurrence risk and is not using other LHRH analogs. Claims will be denied without prior authorization.