Medicare AdvantagePrior AuthLow impact
Iwilfin (eflornithine) (Revised)
Humana·Oncology, Pediatrics·Medicare Advantage
Effective date
Feb 28, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has established new prior authorization requirements for Iwilfin (eflornithine), a specialty medication for high-risk neuroblastoma. Patients must have a confirmed diagnosis and prior partial response to multiagent therapy including anti-GD2 immunotherapy to qualify for coverage.
Action Required
By February 28, 2024: Billing team must ensure prior authorization is obtained for all Iwilfin (eflornithine) prescriptions for Medicare Advantage patients. Verify patient has high-risk neuroblastoma diagnosis and documented partial response to prior multiagent therapy including anti-GD2 immunotherapy before submitting claims. Claims without proper prior authorization will be denied.