Medicare AdvantagePrior AuthMedium impact
Sancuso® (granisetron) transdermal patch (Revised)
Humana·Oncology, Hematology·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Sancuso (granisetron) transdermal patches used to prevent or treat chemotherapy-induced nausea and vomiting. The policy establishes specific criteria including requirements for highly/moderately emetogenic chemotherapy and restrictions on breakthrough treatment use.
Action Required
By January 1, 2025: Billing team must implement prior authorization requirements for all Sancuso (granisetron) transdermal patch prescriptions for Medicare Advantage patients. Providers must document that patients are receiving highly or moderately emetogenic chemotherapy for prevention indication, or that breakthrough treatment criteria are met including no prior 5HT3 receptor antagonist use in the same chemotherapy cycle. Update billing system to flag these prescriptions for prior auth verification before dispensing.