Medicare AdvantagePrior AuthMedium impact
Promacta® (eltrombopag) (Revised)
Humana·Hematology, Oncology, Gastroenterology +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has updated prior authorization requirements for Promacta (eltrombopag) for three conditions: immune thrombocytopenic purpura, hepatitis C-related thrombocytopenia, and aplastic anemia. The policy requires specific platelet count thresholds, documentation of prior treatment failures, and allows 6-month approval periods with renewal criteria.
Action Required
By January 1, 2026: Billing team must update prior authorization procedures for Promacta prescriptions for Medicare Advantage patients. Ensure documentation includes: platelet counts, diagnosis duration (minimum 3 months for ITP), prior treatment failures or contraindications to steroids, and appropriate combination therapies for aplastic anemia. Create workflow to track 6-month approval periods and renewal requirements. Claims without proper prior authorization will be denied.