Plerixafor

Plerixafor (Mozobil) is covered when used to mobilize hematopoietic stem cells for collection prior to autologous transplantation (FDA‑approved for non‑Hodgkin lymphoma and multiple myeloma) and only when administered after G‑CSF or chemo‑mobilization, limited to no more than 4 consecutive days and discontinued after completion of stem‑cell harvest (continuation allowed if initial criteria are still met). All other indications are considered experimental/investigational and excluded (including leukemia, sickle cell disease, COVID‑19, etc.); it is not intended for HSC mobilization in leukemia due to risk of leukemic cell mobilization and is contraindicated in patients with known hypersensitivity.

"Aetna considers plerixafor (Mozobil or generic plerixafor) injection medically necessary when all of the following criteria are met: The requested medicaton will be used to mobilize hematopoietic s..."