CommercialPrior AuthMedium impact
Daratumumab (Darzalex®)
BCBS Tennessee·TN · Oncology, Hematology·Medical Policy
Effective date
Jul 31, 2026
We identified it
Jun 17, 2026
Summary
BlueCross BlueShield of Tennessee has released a new comprehensive medical policy for Daratumumab (Darzalex®) covering multiple myeloma and other conditions, establishing detailed coverage criteria and prior authorization requirements. This policy will not take effect until July 31, 2026, giving practices nearly two years to prepare.
Action Required
Before July 31, 2026: Review and understand the new Daratumumab coverage criteria for multiple myeloma, systemic light chain amyloidosis, T-ALL, POEMS syndrome, MIDD, MGRS, and HIV-related B-cell lymphomas. Prepare to obtain prior authorization for all Daratumumab requests with required documentation including t(11:14) translocation testing where applicable. Update prior authorization workflows to include the specific combination therapy requirements and dosing limits outlined in the policy.