Medicare AdvantagePrior AuthMedium impact
Ferriprox® (deferiprone) (Revised)
Humana·Hematology, Oncology, Pediatrics·Medicare Advantage
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Summary
Humana has revised its prior authorization policy for Ferriprox (deferiprone) for Medicare Advantage plans, requiring documented failure, contraindication, or intolerance to deferasirox tablets before approval. The policy is effective January 1, 2024 with specific criteria for transfusional iron overload secondary to thalassemia syndromes.
Action Required
Immediately: Review current Ferriprox prescriptions for Medicare Advantage patients to ensure prior authorization is obtained. Verify documentation includes diagnosis of transfusional iron overload secondary to thalassemia with transfusion dependence, serum ferritin levels >2,500mcg/L, and evidence of deferasirox failure/contraindication/intolerance. Update prior auth request process to include these specific clinical criteria. Claims without proper prior authorization will be denied.