Medicare AdvantagePrior AuthMedium impact
Nubeqa (darolutamide) (New)
Humana·Oncology, Urology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage is implementing a new prior authorization policy for Nubeqa (darolutamide), a prostate cancer medication, effective January 1, 2026. The policy requires specific clinical criteria to be met for both non-metastatic castration-resistant prostate cancer and metastatic hormone-sensitive prostate cancer indications.
Action Required
By January 1, 2026: Billing and clinical teams must implement prior authorization requirements for Nubeqa (darolutamide) prescriptions for Humana Medicare Advantage members. Update billing system to flag this medication for prior auth. Providers must document diagnosis of non-metastatic castration-resistant prostate cancer or metastatic hormone-sensitive prostate cancer, confirm combination therapy with androgen deprivation therapy, and verify no disease progression while on Nubeqa. Claims will be denied without proper prior authorization.