Medicare AdvantagePrior AuthMedium impact
Inlyta (axitinib) (Revised)
Humana·Oncology, Endocrinology, Urology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has revised prior authorization requirements for Inlyta (axitinib), a cancer medication used for advanced thyroid carcinoma and renal cell carcinoma. The policy establishes specific criteria for coverage approval and excludes members who have experienced disease progression while on this medication.
Action Required
Before January 1, 2026: Billing team must ensure prior authorization is obtained for all Inlyta (axitinib) prescriptions for Humana Medicare Advantage members. Providers must document that patients meet specific criteria: for thyroid cancer - advanced/metastatic disease not responsive to radio-iodine treatment; for kidney cancer - advanced disease with medical contraindication to Cabometyx or as combination therapy with Keytruda/Bavencio. Update encounter forms to remind providers of prior auth requirement. Claims will be denied without proper authorization.