Medicare AdvantagePrior AuthMedium impact
Mavyret™ (glecaprevir/pibrentasvir) (Revised)
Humana·Gastroenterology, Infectious Disease, Internal Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage revised prior authorization requirements for Mavyret (glecaprevir/pibrentasvir) for hepatitis C treatment, requiring failure or contraindication to Epclusa before approval. The policy covers adults, pediatrics, and post-liver transplant patients with specific cirrhosis limitations.
Action Required
By January 1, 2026: Providers must document that patients have failed to achieve sustained virologic response (SVR) after completing a full course of Epclusa or have a contraindication to Epclusa before prescribing Mavyret for hepatitis C treatment. Update prior authorization requests to include this step-therapy requirement. Ensure documentation shows patients are non-cirrhotic or have compensated cirrhosis (Child-Pugh Class A only). Verify no contraindicated medications are being used concurrently.