CommercialPrior AuthMedium impact
Talquetamab-tgvs (Talvey™)
BCBS Tennessee·TN · Oncology, Hematology, Nephrology·Medical Policy
Effective date
Jul 31, 2026
We identified it
Jun 17, 2026
Summary
BlueCross BlueShield of Tennessee is implementing a new medical policy for Talquetamab-tgvs (Talvey™), a cancer drug for multiple myeloma and related conditions, requiring prior authorization with specific coverage criteria. The policy covers FDA-approved uses and several compendial uses but requires documentation of prior therapy failures.
Action Required
By July 31, 2026: Billing and prior authorization teams must update systems to require prior authorization for Talquetamab-tgvs (Talvey™) prescriptions. Providers must document patient's previous therapy history including specific drug categories (proteasome inhibitors, immunomodulatory agents, anti-CD38 antibodies) and number of prior treatments. Update EMR templates to capture required documentation for multiple myeloma, POEMS syndrome, MIDD, and MGRS indications.