MedicaidPrior AuthMedium impact
Jevtana® (cabazitaxel) (Revised)
Humana·LA · Oncology·Medicaid
Effective date
Sep 1, 2025
We identified it
Jul 21, 2026
Summary
Humana Medicaid (Louisiana) has revised its Jevtana (cabazitaxel) prior authorization policy effective September 1, 2025. The policy requires prior authorization for this intravenous chemotherapy drug and mandates three specific approval criteria: (1) diagnosis of hormone-refractory metastatic prostate cancer, (2) prior docetaxel treatment, and (3) concurrent corticosteroid use. Three key exclusions prohibit use in patients with neutrophils ≤1,500/mm³, hepatic impairment (total bilirubin >3× ULN), or concomitant use with abiraterone acetate, Yonsa, or Xtandi.
Action Required
Before September 1, 2025: (1) Billing team must configure billing system to require prior authorization for Jevtana (cabazitaxel) J9017 for all Humana Medicaid Louisiana members. (2) Update prior authorization submission templates to include verification of all three approval criteria: hormone-refractory metastatic prostate cancer diagnosis, prior docetaxel treatment history, and concurrent corticosteroid prescription. (3) Add screening checklist in system to flag and reject requests if any exclusion criteria are present (neutrophil count ≤1,500/mm³, total bilirubin >3× ULN, or concurrent abiraterone/Yonsa/Xtandi use). (4) Train billing and clinical staff on the three mandatory approval criteria and three exclusions. (5) Notify oncology providers in Louisiana of new requirements. Claims submitted without prior authorization or failing to meet criteria will be denied.