Medical Policy Updates

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Notification of Policy Revisions Effective May 4, 2021 Posted February 23, 2021

Medical Policy Revision
Eculizumab (Soliris®) “Notification” Added the following criteria within "When Covered" section for aHUS and PNH: "the patient has tried and had an inadequate response to ravulizumab (Ultomiris), OR the patient has a clinical contraindication or intolerance to ravulizumab (Ultomiris)." Policy notification given 2/23/2021 for effective date 5/4/2021.