Mecasermin (Increlex)

Mecasermin (Increlex) is covered for long‑term treatment of children (generally ≥2 years) with severe primary IGF‑1 deficiency or with GH gene deletion who have developed neutralizing antibodies to GH, and is not considered medically necessary once epiphyses are fused or enrollment criteria are not met. Coverage requires pretreatment height ≤ −3 SD and basal IGF‑1 ≤ −3 SD for age/gender, exclusion of pediatric GH deficiency by a provocative GH test with peak GH ≥10 ng/mL, open epiphyses (X‑ray confirmed or unavailable), and continuation requires growth >2 cm/year or a documented clinical reason for lack of efficacy (e.g., <1 year on therapy or nearing final adult height).

"Continuation criteria require growth rate >2 cm/year or documented clinical reason for lack of efficacy (e."

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