Mifepristone (300 mg) prior authorization for Cushing's syndrome–related hyperglycemia
This policy governs prior authorization for mifepristone 300 mg tablets under the pharmacy benefit for Mass General Brigham Health Plan commercial/exchange members; it applies to specialty pharmacy dispensing and adults with endogenous Cushing's syndrome–related hyperglycemia who require treatment.
Updated initial authorization criteria to remove previous trial therapy requirement.
Generic Korlym (mifepristone) was added to criteria/coverage language.
Reauthorization criteria now require documentation of a positive clinical response to therapy.
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.