Medicare AdvantagePrior AuthLow impact
Nilotinib products (Tasigna, nilotinib) (Revised)
Humana·Hematology, Oncology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has revised their prior authorization policy for nilotinib products (Tasigna) used to treat chronic myelogenous leukemia (CML), acute lymphoblastic leukemia (ALL), and gastrointestinal stromal tumors (GIST). The policy includes specific criteria for brand Tasigna requiring intolerance or contraindication to generic nilotinib, with mutations T315I, Y253H, E255K/V or F359V/C/I as exclusions.
Action Required
By January 1, 2026: Providers treating patients with CML, ALL, or GIST must obtain prior authorization for all nilotinib products through Humana Medicare Advantage. Ensure documentation includes Philadelphia chromosome status, disease phase, prior treatment history, and for brand Tasigna requests, document intolerance or contraindication to generic nilotinib. Verify patients do not have excluded mutations (T315I, Y253H, E255K/V or F359V/C/I) before submitting authorization requests.