Medicare AdvantagePrior AuthMedium impact
Cosela™ (trilaciclib) (Revised)
Humana·FL, KY, SC · Oncology·Medicaid
Effective date
Mar 25, 2026
We identified it
Jun 25, 2026
Summary
Humana revised its Cosela (trilaciclib) prior authorization policy effective March 25, 2026. This policy covers the use of Cosela to decrease chemotherapy-induced myelosuppression in adult patients with extensive-stage small cell lung cancer receiving platinum/etoposide or topotecan-containing chemotherapy regimens. Prior authorization is required for all requests, with approval granted for the initial and renewal plan year duration or as clinically determined.
Action Required
By March 25, 2026: Billing team must implement prior authorization requirements for all Cosela (trilaciclib) intravenous claims in affected states. Update billing system to flag Cosela requests and require verification of three criteria before claim submission: (1) member has extensive-stage small cell lung cancer diagnosis, (2) Cosela is being used to decrease chemotherapy-induced myelosuppression, and (3) member is receiving platinum/etoposide or topotecan-containing chemotherapy. Providers must document concurrent chemotherapy regimen in all requests. Obtain prior authorization through www.humana.com/PAL using appropriate medical coding. Claims submitted without prior authorization will be denied. Educate oncology staff and providers in Florida, Kentucky, and South Carolina practices about new prior auth workflow.