CommercialPrior AuthMedium impact
Octreotide Suspension (Sandostatin® LAR Depot), Octreotide Acetate for Injectable Suspension
BCBS Tennessee·TN · Oncology, Endocrinology, Gastroenterology +1 more·Pharmacy
Effective date
Jul 31, 2026
We identified it
Jun 17, 2026
Summary
BlueCross BlueShield of Tennessee is implementing a new policy for octreotide suspension (Sandostatin LAR Depot) that establishes prior authorization requirements and specific coverage criteria for multiple conditions including acromegaly, neuroendocrine tumors, and various gastrointestinal disorders. The policy requires specific documentation and laboratory results for approval and continuation of therapy.
Action Required
Before July 31, 2026: Billing and clinical teams must implement prior authorization processes for octreotide suspension prescriptions. Update EMR templates to capture required documentation including IGF-1 levels for acromegaly patients, grade 3/4 diarrhea documentation for cancer patients, and clinical notes showing inadequate surgical response. Train staff on 12-month vs 6-month authorization periods depending on indication. Failure to obtain prior auth and provide required documentation will result in claim denials.