Medicare AdvantagePrior AuthMedium impact
Daurismo™ (glasdegib) (Revised)
Humana·Oncology, Hematology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Aug 12, 2026
Summary
Humana has revised its Daurismo (glasdegib) pharmacy coverage policy for Medicare Advantage members with newly-diagnosed acute myeloid leukemia (AML). The policy requires prior authorization and specifies strict eligibility criteria: members must be age 75+ OR have comorbidities precluding intensive chemotherapy, AND must use Daurismo in combination with low-dose cytarabine. The policy excludes members who have experienced disease progression on Daurismo.
Action Required
By January 1, 2026: Billing team must implement prior authorization requirements for all Daurismo (glasdegib) claims for Humana Medicare Advantage members. Oncology practices must verify patient eligibility before billing: (1) confirm newly-diagnosed AML diagnosis, (2) document patient age ≥75 years OR presence of qualifying comorbidities (severe cardiac disease, ECOG performance status ≥2, or serum creatinine >1.3 mg/dL), and (3) confirm concurrent use with low-dose cytarabine. Obtain prior authorization from Humana before dispensing or billing. Update claim submission templates and provider education materials to reflect these requirements. Flag any claims for members with documented disease progression on Daurismo as non-approvable. Failure to obtain prior authorization will result in claim denials. Reference Humana's Preauthorization and Notification List (PAL) at www.humana.com/PAL for claim code requirements.