Medicare AdvantagePrior AuthHigh impact
Varubi (rolapitant) (Revised)
Humana·Oncology, Hematology·Medicare Advantage
Effective date
Jan 1, 2024
We identified it
Jun 25, 2026
Summary
Humana updated its Varubi (rolapitant) prior authorization policy effective January 1, 2024, with a revision date of June 25, 2025. The policy requires prior authorization for Varubi tablet (90mg) when used for chemotherapy-induced nausea and vomiting prevention. Key requirements include: (1) documented failure or contraindication with aprepitant, (2) concurrent use with corticosteroid and 5-HT3 antagonist, and (3) use with highly or moderately emetogenic chemotherapy. The policy explicitly excludes concurrent use with IV Emend, oral Emend 150mg, Akynzeo, or Cinvanti.
Action Required
By July 10, 2025: Billing and clinical teams must implement prior authorization requirements for all Varubi (rolapitant) tablet requests. (1) Update billing system to flag Varubi claims for prior authorization review before submission to Humana Medicare Advantage plans. (2) Providers must document: failure/contraindication to aprepitant, concurrent corticosteroid and 5-HT3 antagonist use, and chemotherapy emetogenicity level (HEC or MEC) in all authorization requests. (3) Front desk and authorization staff must verify member is NOT receiving IV Emend, oral Emend 150mg, Akynzeo, or Cinvanti—if concurrent use detected, deny authorization. (4) Update encounter forms and clinical templates to capture required documentation elements. (5) Train billing staff on exclusion criteria and denial reasons. Failure to obtain prior authorization will result in claim denials; concurrent prohibited medications will trigger automatic denials.