Xolair® (omalizumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plansopen_in_new
Prior authorization/notification policy for Xolair (omalizumab) prefilled syringe and autoinjector formulations for self-administered subcutaneous use across UnitedHealthcare commercial plans; defines initial and reauthorization clinical criteria for asthma, chronic spontaneous urticaria, chronic rhinosinusitis with nasal polyps, and IgE-mediated food allergy, plus exclusions and administrative notes.
Effective date set to 7/1/2025 and program applies to prefilled syringe and autoinjector formulations.
Added criteria for new indication, IgE-mediated food allergy (4/2024).
Annual reviews with updates to list of agents not to be used in combination with Xolair (added Tezspire).
4/2025 annual review documented; no changes to coverage criteria.
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