Syfovre™ (pegcetacoplan injection)

Syfovre (pegcetacoplan) is covered only for geographic atrophy secondary to age‑related macular degeneration (other indications excluded), with authorization limited to 12 months. Coverage requires documentation of GA due to AMD, BCVA of ≥24 ETDRS letters or ≥20/320 Snellen, administration by or under an ophthalmologist, and records showing 15 mg intravitreal dosing to each affected eye every 25–60 days.

"Syfovre is indicated for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD)."

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