Prior authorization required

Does Upmc Health Network, INC. require prior authorization for Zarxio?

Upmc Health Network, INC. requires prior authorization for Zarxio on every Medicare Part D plan of theirs that covers it.

Every plan from this payer that covers the drug requires authorization before it is dispensed.

By product strength

RxNorm product	Plans covering	Require prior auth	Step therapy	Qty limit	Status
0.5 ML filgrastim-sndz 0.6 MG/ML Prefilled Syringe [Zarxio]1605071	12 / 12	12	0	0	Prior authorization required
0.8 ML filgrastim-sndz 0.6 MG/ML Prefilled Syringe [Zarxio]1605075	12 / 12	12	0	0	Prior authorization required

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — 0.5 ML filgrastim-sndz 0.6 MG/ML Prefilled Syringe [Zarxio]

Zarxio has 2 products in the corpus; this table is for 0.5 ML filgrastim-sndz 0.6 MG/ML Prefilled Syringe [Zarxio], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
UPMC for Life PPO Essential Care Rx (PPO)	H5533-017	5	Yes	No	No
UPMC for Life PPO Essential Care Rx (PPO)	H5533-017	5	Yes	No	No
UPMC for Life PPO High Deductible Rx (PPO)	H5533-003	5	Yes	No	No
UPMC for Life PPO Premier Rx (PPO)	H5533-011	5	Yes	No	No
UPMC for Life PPO Premier Rx (PPO)	H5533-013	5	Yes	No	No
UPMC for Life PPO Rx Choice (PPO)	H5533-015	5	Yes	No	No
UPMC for Life PPO Rx Choice (PPO)	H5533-015	5	Yes	No	No
UPMC for Life PPO Rx Choice (PPO)	H5533-015	5	Yes	No	No
UPMC for Life PPO Rx Choice (PPO)	H5533-015	5	Yes	No	No
UPMC for Life PPO Rx Choice (PPO)	H5533-015	5	Yes	No	No
UPMC for Life PPO Rx Enhanced (PPO)	H5533-005	5	Yes	No	No
UPMC for Life PPO Rx Enhanced (PPO)	H5533-008	5	Yes	No	No

Source

Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File

Effective: 2026-06-30
Retrieved: 2026-07-19
SHA-256: e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Zarxio at other payers

Or see Zarxio across every payer at once.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.