CommercialPrior AuthMedium impact
Lanreotide (Somatuline® Depot; Lanreotide)
BCBS Tennessee·TN · Endocrinology, Oncology, Gastroenterology·Medical Policy
Effective date
Jul 31, 2026
We identified it
Jun 17, 2026
Summary
BCBS Tennessee is implementing a new medical policy for Lanreotide (Somatuline Depot) with step therapy requirements and specific prior authorization criteria for acromegaly and neuroendocrine tumors. The policy requires documentation of high IGF-1 levels for acromegaly and allows 12-month authorizations for various covered indications.
Action Required
Before July 31, 2026: Billing team must update prior authorization workflows for Lanreotide (Somatuline Depot) to require step therapy documentation and specific lab results. For acromegaly cases, obtain high pretreatment IGF-1 levels and documentation of inadequate response to surgery/radiotherapy. For continuation requests, submit current IGF-1 levels showing improvement. Reference the BCBS step therapy guide at provided URL for complete requirements.