Medicare AdvantagePrior AuthLow impact
Cobenfy™ (xanomeline-trospium) (Revised)
Humana·Psychiatry·Medicare Advantage
Effective date
Nov 27, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Cobenfy (xanomeline-trospium), a new schizophrenia medication. Patients must be 18+ and have tried at least two generic atypical antipsychotics before approval.
Action Required
Immediately: Clinical staff must obtain prior authorization from Humana before prescribing Cobenfy for Medicare Advantage patients with schizophrenia. Verify patient meets criteria: age 18+, tried at least 2 generic alternatives (olanzapine, risperidone, aripiprazole, quetiapine, lurasidone, or ziprasidone), and no contraindications (urinary retention, hepatic impairment, gastric retention, untreated narrow-angle glaucoma). Claims will be denied without prior authorization.