MedicaidPrior AuthLow impact
Ixempra (ixabepilone) (New)
Humana·OH · Oncology·Medicaid
Effective date
Nov 1, 2025
We identified it
Jun 24, 2026
Summary
Humana has implemented a new prior authorization policy for Ixempra (ixabepilone), a chemotherapy drug for metastatic breast cancer, effective November 1, 2025, for Ohio Medicaid patients. The policy requires specific criteria including resistance to previous therapies and excludes patients with severe hypersensitivity reactions or liver impairment when used with capecitabine.
Action Required
By November 1, 2025: Billing and clinical teams must implement prior authorization requirements for Ixempra (ixabepilone) prescriptions for Ohio Medicaid patients. Ensure documentation shows diagnosis of locally advanced or metastatic breast cancer and resistance to anthracycline, taxane, and capecitabine therapies. Verify patients do not have exclusion criteria including severe hypersensitivity reactions or liver impairment. Claims without prior authorization will be denied.