CommercialCoverageMedium impact
08.01.02h, Pegloticase (Krystexxa®)
Independence Blue Cross·Rheumatology, Nephrology, Internal Medicine +1 more·Pharmacy
Effective date
Apr 30, 2025
We identified it
Jun 19, 2026
Summary
IBX Commercial plans updated their pegloticase (Krystexxa®) pharmacy policy with a reissue effective April 30, 2025. This is a fresh policy update that may affect coverage, prior authorization, or billing requirements for this gout medication used when other treatments have failed.
Action Required
By April 30, 2025: Review the complete updated policy at the provided URL to identify specific changes to pegloticase coverage, prior authorization requirements, or documentation needs. Update billing procedures and prior auth workflows accordingly for IBX Commercial patients receiving Krystexxa therapy.