Medicare AdvantagePrior AuthLow impact
Zokinvy ™ (lonafarnib) (New)
Humana·Pharmacy, Genetics, Pediatrics·Medicare Advantage
Effective date
Feb 25, 2026
We identified it
Jun 25, 2026
Summary
Humana Medicare Advantage has established a new prior authorization policy for Zokinvy (lonafarnib), effective February 25, 2026. Coverage is limited to patients with Hutchinson-Gilford Progeria Syndrome or Progeroid Laminopathies with specific genetic mutations, and requires a minimum body surface area of 0.39 m². All Zokinvy prescriptions require prior authorization before dispensing.
Action Required
By February 25, 2026: Pharmacy billing staff must implement prior authorization requirements for all Zokinvy (lonafarnib) prescriptions. Update pharmacy management system to flag Zokinvy claims for prior authorization review before submission. Ensure prescribers document: (1) confirmed diagnosis of Hutchinson-Gilford Progeria Syndrome OR Progeroid Laminopathies with specified LMNA or ZMPSTE24 mutations, and (2) patient body surface area ≥0.39 m². Front desk and pharmacy staff must verify prior authorization approval before dispensing. Clinical staff should be aware of extensive CYP3A drug interactions. Failure to obtain prior authorization will result in claim denials. Reference Humana's current online policy before each submission, as printed copies become uncontrolled.