Voyxact® (sibeprenlimab-szsi) subcutaneous injection (Revised)

By January 28, 2026: Billing and prior authorization teams must implement Voyxact (sibeprenlimab-szsi) prior authorization protocol for all Humana Medicare Advantage members. ACTION STEPS: (1) Update billing system and EMR to flag all Voyxact subcutaneous injection claims for mandatory prior authorization; (2) Create/activate prior auth request template requiring verification of: confirmed primary IgAN diagnosis by biopsy (Criteria #1), indication for slowing kidney function decline (Criteria #2), and baseline eGFR ≥30 mL/min/1.73 m2 prior to treatment start (Criteria #3); (3) Train clinical review staff on APRIL blocker mechanism and KDIGO IgAN management recommendations; (4) Add warnings regarding live vaccine avoidance (30 days prior and during therapy) and infection risk monitoring to prior auth checklist; (5) Instruct providers to submit prior authorization requests through www.humana.com/PAL using applicable preauthorization/notification codes; (6) Update claim submission protocols to deny or pend claims lacking valid prior authorization. RESPONSIBILITY: Prior Authorization Department (setup), Billing Team (claim processing), Clinical Review Staff (medical necessity review). CONSEQUENCE: Claims submitted without prior authorization will be denied; resubmission will delay member access to this kidney-protective therapy.