Xenpozyme (olipudase alfa-rpcp)

Xenpozyme (olipudase alfa‑rpcp) is covered only for non‑CNS manifestations of ASMD in adults and children and is excluded for CNS disease and ASMD types other than type B or A/B. Authorization requires documented ASM enzymatic assay and mutation testing with exclusion of Gaucher disease, clinical evidence of ASMD type B or A/B with ≥2 non‑CNS signs, prescription by or consultation with a geneticist/endocrinologist/metabolic/lysosomal storage disorder specialist, adherence to specified weight/BMI‑based dose‑escalation and dosing rules, and is approved for 12 months.

"Clinical documentation showing the patient has ASMD type B OR ASMD type A/B."

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