Medicare AdvantagePrior AuthMedium impact
Zolinza® (vorinostat) (Revised)
Humana·Oncology, Hematology·Medicare Advantage
Effective date
Jan 1, 2020
We identified it
Jun 25, 2026
Summary
This is a revised Humana Medicare Advantage prior authorization policy for Zolinza® (vorinostat), a histone deacetylase inhibitor used to treat cutaneous T-cell lymphoma (CTCL). The policy was last revised on January 28, 2026 (1 day old). The policy requires prior authorization for Zolinza and specifies that coverage applies only to patients with progressive, persistent, or recurrent CTCL disease or those receiving it as primary/adjuvant therapy. Treatment may continue as long as there is no disease progression or unacceptable toxicity.
Action Required
Immediately: Billing team must ensure all Zolinza (vorinostat) claims for Medicare Advantage members include prior authorization before submission. Verify that claims processing systems are configured to flag Zolinza prescriptions for prior authorization review. Before submitting any Zolinza claim, confirm the patient has a documented diagnosis of progressive, persistent, or recurrent CTCL or is receiving the drug as primary/adjuvant therapy. Claims submitted without prior authorization will be denied. Additionally, inform providers that Zolinza must be taken with food and that patients should not open or crush capsules. Direct patients to Merck's patient assistance program at www.merckhelp.com for out-of-pocket cost support.