All PlansCoverageMedium impact
Drug Policy Criteria Change
Arkansas Blue Cross Blue Shield·Oncology, Dermatology, Pharmacy·Pharmacy
Effective date
Sep 27, 2026
We identified it
Sep 12, 2026
Summary
This policy updates drug coverage criteria for three medications: Opdivo now covers combination use with Tudriqev for cutaneous melanoma (effective 09/27/2026), Zolymbus is added to the target drug list while Lumigan is removed due to generic availability (effective 10/01/2026). Billing teams must update formulary references and prior authorization rules accordingly.
Action Required
By September 27, 2026: Billing and pharmacy teams must update the formulary system to reflect Opdivo's expanded coverage for combination therapy with Tudriqev in cutaneous melanoma cases. By October 1, 2026: Remove Lumigan from all target drug lists and update prior authorization rules to replace Lumigan with Zolymbus. Verify that billing software reflects these formulary changes before the effective dates to avoid claim denials. Notify providers of the Lumigan-to-Zolymbus transition to prevent inappropriate prescribing of a non-covered drug.