Effective January 1, 2026, prior authorization will be required for all denosumab products, including biosimilars, for commercial Blue Cross of Alabama members.
- Preferred: Jubbonti/Wyost and Stoboclo/Osenvelt
- Non-preferred: All other denosumab formulations
- Patients currently on Prolia or Xgeva will have authorizations auto-loaded to maintain continuity of care.
For PEEHIP plans, beginning October 1, 2025, the same preferred products apply. All other denosumab versions will be non-covered, with proactive authorizations added for current patients.
Additional PEEHIP medical drug updates (effective Jan. 1, 2026) include changes to coverage and preferred products across multiple drug classes, such as myasthenia gravis therapies, pegfilgrastim, trastuzumab, bevacizumab, rituximab, and ocular VEGF treatments. Most updates follow a preferred-first or step-therapy structure, with limited continuation allowances for stable patients on non-preferred products.
New provider-administered drug fees will also take effect Nov. 1, 2025, available in the PMD and Select fee schedules via ProviderAccess.
Resource: Denosumab Products Update: Prior Authorization Required