Medicare AdvantagePrior AuthMedium impact
Alternate nilotinib products (Danziten, Cavhanza, nilotinib tartrate-Cipla) (Revised)
Humana·Oncology, Hematology, Pharmacy·Medicare Advantage
Effective date
Feb 26, 2025
We identified it
Aug 6, 2026
Summary
Humana has established a prior authorization policy for three alternate nilotinib products (Danziten, Cavhanza, and nilotinib tartrate-Cipla) used to treat chronic myeloid leukemia in Medicare Advantage members. The policy requires prior authorization and applies only to members age 18+ with CML diagnosis, with an exclusion for members who have experienced disease progression on any nilotinib product.
Action Required
By February 26, 2025: Billing and prior authorization teams must implement prior authorization requirements for Danziten (nilotinib d-tartrate), Cavhanza (nilotinib disintegrating tablet), and nilotinib tartrate-Cipla capsules for all Medicare Advantage members. Update billing system to flag these medications for prior auth review. Ensure authorization staff review claims against the two approval criteria: (1) CML diagnosis confirmed, (2) member age 18+, and apply the exclusion if member has experienced disease progression on any nilotinib product. Providers should be notified that prior authorization is required before dispensing these alternate nilotinib products to Medicare Advantage members. Claims submitted without prior authorization will be denied. Reference Humana's Preauthorization and Notification List (PAL) at www.humana.com/PAL for provider claim codes.