Skytrofa (lonapegsomatropin) coverage for growth hormone deficiency
Cigna Coverage Policy (IP0375) defines prior authorization requirements, medical necessity criteria, reauthorization, preferred product/step requirements, exclusions, and authorization durations for Skytrofa (lonapegsomatropin) for pediatric and adult growth hormone deficiency across multiple plan types.
Removed preferred product requirements from the Standard, Value and Legacy formularies.
Updated Individual and Family plan preferred product requirements.
Updated the Employer Plans preferred product requirements.
Policy Statement updated to include clinician (pharmacist or nurse) for verification of criteria; added 'at least' to requirement for two GH stimulation tests < 10 ng/mL; added continuation criterion related to mid-parental height not obtained; added adult/transition adolescent criteria and documentation requirements.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.