Medicare AdvantagePrior AuthMedium impact
Bynfezia Pen® (octreotide acetate) injection
Humana·Endocrinology, Oncology, Gastroenterology +1 more·Medicare Advantage
Effective date
Nov 26, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Bynfezia Pen (octreotide acetate) injection across five specific conditions. All patients must have failed or shown intolerance to generic subcutaneous octreotide and Sandostatin LAR Depot before Bynfezia Pen can be approved.
Action Required
By November 26, 2025: Billing team must update systems to flag Bynfezia Pen prescriptions for prior authorization requirements under Humana Medicare Advantage plans. Providers must document previous treatment failure or intolerance with generic octreotide and Sandostatin LAR Depot for all five covered conditions (acromegaly, carcinoid tumors, VIPomas, chemotherapy/radiation-induced diarrhea, AIDS-related diarrhea). Claims submitted without proper prior authorization will be denied.