Medicare AdvantagePrior AuthMedium impact
Varubi (rolapitant) (Revised)
Humana·Oncology, Pharmacy·Medicare Advantage
Effective date
Jan 1, 2024
We identified it
Jul 2, 2026
Summary
This revised Humana Medicare Advantage policy (revised June 24, 2026) establishes prior authorization requirements for Varubi (rolapitant) tablet for chemotherapy-induced nausea/vomiting prevention. Key requirements include: member must have failed aprepitant or have contraindications, must be on concurrent corticosteroid and 5-HT3 antagonist, and must be receiving highly or moderately emetogenic chemotherapy. Varubi cannot be used concurrently with IV/oral Emend, Akynzeo, or Cinvanti.
Action Required
By immediately: Billing and clinical teams must implement prior authorization workflow for all Varubi (rolapitant) tablet requests on Medicare Advantage plans. (1) Update billing system to require prior auth before claim submission; (2) Develop PA request template documenting: evidence of aprepitant failure/contraindication/side effects, concurrent use of dexamethasone and 5-HT3 antagonist (ondansetron, dolasetron, palonosetron, or granisetron), and HEC/MEC chemotherapy use; (3) Train providers to include these clinical details in PA submissions; (4) Add system validation to prevent concurrent billing with IV Emend, oral Emend 150mg, Akynzeo, or Cinvanti; (5) Confirm BvsD Coverage Determination requirements with Humana before submission if applicable. Failure to obtain prior authorization will result in claim denials. Note: Policy revised June 24, 2026, with review date June 17, 2026—verify current version at Humana website before processing.