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CommercialCoverageMedium impact

08.01.02h, Pegloticase (Krystexxa®)

Independence Blue Cross·Rheumatology, Nephrology, Internal Medicine·Pharmacy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Days to comply
—

Summary

The Pegloticase (Krystexxa®) pharmacy policy has been reissued with updates effective April 1, 2026. This policy governs coverage and requirements for this specialty gout medication used to treat chronic refractory gout.

Action Required

Action needed
By April 1, 2026: Review updated Pegloticase (Krystexxa®) policy requirements for coverage criteria, prior authorization, and documentation needs. Billing team should access the full policy at the provided URL to understand specific changes to coverage guidelines and update billing procedures accordingly.

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