Medicare AdvantagePrior AuthMedium impact
Bizengri (zenocutuzumab-zbco) (Revised)
Humana·KY, SC · Oncology·Medicaid
Effective date
Nov 26, 2025
We identified it
Jun 24, 2026
Summary
Humana has established a new prior authorization policy for Bizengri (zenocutuzumab-zbco), a specialty cancer drug for treating NRG1 gene fusion positive non-small cell lung cancer and pancreatic adenocarcinoma. Prior authorization is required for Medicare and Medicaid members in Kentucky and South Carolina, with specific criteria including advanced/metastatic disease, genetic testing confirmation, and previous systemic therapy.
Action Required
By November 26, 2025: Billing team must update prior authorization requirements for Bizengri (zenocutuzumab-zbco) for Humana Medicare and Medicaid members in Kentucky and South Carolina. Ensure oncology providers document NRG1 gene fusion positive status, advanced/unresectable/metastatic disease, and prior systemic therapy before prescribing. Claims without prior authorization will be denied.