MedicaidPrior AuthMedium impact
Sarclisa (isatuximab-irfc) (Revised)
Humana·LA · Oncology, Hematology·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has updated the prior authorization policy for Sarclisa (isatuximab-irfc), an IV cancer medication for multiple myeloma treatment. The policy now covers three specific indications with detailed criteria for third-line therapy, relapsed/refractory cases, and newly diagnosed patients ineligible for stem cell transplant.
Action Required
By December 1, 2025: Prior authorization team must update systems to require pre-approval for Sarclisa (isatuximab-irfc) for Louisiana Medicaid members. Verify patient meets specific combination therapy requirements (with pomalidomide/dexamethasone, carfilzomib/dexamethasone, or bortezomib/lenalidomide/dexamethasone) and prior therapy history before submitting requests. Claims will be denied without proper prior authorization.