Medicare AdvantagePrior AuthMedium impact
Tyrvaya® (varenicline) (Revised)
Humana·Ophthalmology, Optometry·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Tyrvaya (varenicline) nasal spray used to treat dry eye disease. Patients must have a dry eye diagnosis and have failed or have contraindications to both cyclosporine eye drops and Eysuvis before Tyrvaya will be approved.
Action Required
By January 1, 2025: Billing team must implement prior authorization requirements for Tyrvaya (varenicline) nasal spray prescriptions for Humana Medicare Advantage patients. Providers must document dry eye disease diagnosis and previous treatment failure or contraindications to cyclosporine eye drops (generic Restasis) AND Eysuvis (loteprednol) before prescribing. Update EMR templates to include this documentation checklist. Claims without proper prior authorization will be denied.