Caplacizumab-yhdp (Cablivi)

This policy authorizes Cablivi only for adults (≥18) with acquired TTP as adjunctive therapy to plasma exchange and immunosuppressive therapy (not for non‑FDA indications) when prescribed by or in consultation with a hematologist. Approval is for 3 months with required dosing (11 mg IV bolus ≥15 minutes before first plasma exchange, then 11 mg SC post‑exchange daily and for 30 days after last exchange; extension up to 28 days only if ADAMTS13 activity remains suppressed), requires documentation of diagnosis, age, concurrent immunosuppression, plasma exchange initiation and dosing, and discontinuation if >2 recurrences on therapy.

"Cablivi is indicated for the treatment of adult patients with acquired thrombotic thrombocytopenic purpura (aTTP), in combination with plasma exchange and immunosuppressive therapy."

Sign up to see full coverage criteria, indications, and limitations.