Apomorphine (Apokyn, Apokyn NXT, Onapgo)
Clinical policy detailing medical necessity criteria, initial and continuation approval criteria, dosing limits, contraindications, prior authorization requirements, formulation-specific limits, and coding implications for apomorphine products (Apokyn, Apokyn NXT, Onapgo) across Commercial, HIM, and Medicaid lines of business.
Added step therapy bypass for IL HIM per IL HB 5395 (effective 01/01/2026 noted in policy body; entry dated 06.27.25).
Added formulations Apokyn NXT and Onapgo to policy and added requirement to use generic apomorphine for Apokyn/Apokyn NXT unless contraindicated.
Removed Kynmobi (sublingual apomorphine) formulation from policy due to market withdrawal by manufacturer.
Added HCPCS codes J3490 and C9399 to coding implications.