All PlansPrior AuthMedium impact
Drug Policy Criteria Change
Arkansas Blue Cross Blue Shield·Psychiatry, Neurology, Ophthalmology +2 more·Pharmacy
Effective date
Nov 1, 2025
We identified it
Jun 19, 2026
Summary
This policy updates drug criteria for four medications: Daybue gets new criteria replacing retired ones, Spravato approval duration extends from 6 to 12 months for treatment-resistant depression, and Omlonti is added to the prostaglandin analogues target drug list. These changes affect Standard, Metallic, and Essential formulary tiers with effective dates ranging from November 2025 to August 2026.
Action Required
Before November 1, 2025: Billing team must review and update prior authorization requirements for Daybue, Spravato, and Omlonti prescriptions. Update billing software to reflect new criteria effective dates through August 2026. Notify providers that Spravato approvals for treatment-resistant depression now extend to 12 months instead of 6 months, and Omlonti requires prior authorization under prostaglandin analogues criteria.