Medicare AdvantagePrior AuthLow impact
Duvyzat (givinostat) (Revised)
Humana·Neurology, Pediatrics·Medicare Advantage
Effective date
Sep 25, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Duvyzat (givinostat) oral suspension for treating Duchenne Muscular Dystrophy. Seven specific criteria must be met for initial approval, including confirmed DMD diagnosis, specialist prescription, ambulatory status, and stable corticosteroid use for 6+ months.
Action Required
Immediately: Update billing team protocols to require prior authorization for Duvyzat (givinostat) oral suspension prescriptions for Humana Medicare Advantage members. Ensure providers document all seven required criteria including DMD genetic testing confirmation, specialist consultation, ambulatory status, 6+ months stable corticosteroid use, and baseline functional test results. Add PA requirement to pharmacy billing system to prevent claim denials.