CommercialCoverageMedium impact
Drug Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Oncology, Neurology, Endocrinology +1 more·Pharmacy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross updated drug policy criteria for multiple medications including Stivarga (expanded cancer coverage), Wakix (expanded to children 6+ for narcolepsy), consolidated MS drug criteria, and updated Ozempic tablet naming. Changes affect pharmacy benefit coverage and prior authorization requirements.
Action Required
Before February 27, 2026: Billing team must update prior authorization systems for consolidated MS drug criteria. Before March 29, 2026: Update drug formulary references for Stivarga expanded cancer indications and Wakix pediatric coverage. Before April 1, 2026: Update all references from 'Rybelsus (R2 formulation)' to 'Ozempic tablets' in billing systems and prior authorization forms to match new labeling requirements.