UnitedHealthcare updated several pulmonary and cystic fibrosis drug programs effective March–May 2026. Nucala (mepolizumab) COPD criteria were broadened, removing a chronic productive cough requirement and lowering the post-bronchodilator FEV1 threshold (documentation truncated), and the autoinjector and prefilled syringe formulations remain in scope (medical necessity, 3/1/2026). The Interstitial Lung Disease Agents program added Jascayd (nerandomilast) and reclassified Ofev (nintedanib) into an explicit progressive pulmonary fibrosis category with new coverage criteria (notification/medical necessity, 4/1/2026). Pulmozyme, Cayston, Trikafta and multiple CF/inhaled agents underwent annual review with no coverage changes (5/1/2026), while numerous other products had administrative reference updates or new program notifications introduced across the commercial formulary.
March–May 2026 Revision Highlights (UnitedHealthcare pulmonary agents)
Summary of revisions effective 2026-03-01 and 2026-05-01
This document records a series of annual reviews and program changes across multiple pulmonary and related agents in UnitedHealthcare's commercial business. Key effective dates in the source text include 3/1/2026 for certain biologic and specialty agents (e.g., Litfulo, Livdelzi, Mektovi, Nucala) and 5/1/2026 for a larger bundle of respiratory and cystic fibrosis agents (e.g., Cayston, Pulmozyme, Trikafta). Several items also list an implementation date of 4/1/2026 for interstitial lung disease agents and other newly created programs.
The file documents both routine annual reviews with no coverage changes and substantive edits: the Nucala criteria for COPD were updated (partial criteria shown in the source) and the Interstitial Lung Disease Agents program was expanded to add Jascayd and to revise Ofev placement and coverage for progressive pulmonary fibrosis. Additionally, multiple new programs are introduced (e.g., , , ) and several products had references/background updated without coverage changes.
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