CommercialPrior AuthMedium impact
08.01.94d, Nivolumab and Relatlimab-rmbw (Opdualag™) for intravenous use
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jun 16, 2025
We identified it
Jun 19, 2026
Summary
The medical necessity criteria for Nivolumab and Relatlimab-rmbw (Opdualag™) intravenous therapy have been updated for commercial insurance plans. This affects prior authorization requirements and coverage determination for this oncology combination immunotherapy drug.
Action Required
By June 16, 2025: Review updated medical necessity criteria for Opdualag™ (Nivolumab and Relatlimab-rmbw) prescriptions. Update prior authorization documentation requirements in billing system and ensure providers are aware of new criteria for commercial plan approvals. Verify current criteria at the IBX policy portal before submitting authorization requests.