Syfovre™ (pegcetacoplan injection)

Covered: Syfovre (pegcetacoplan) is authorized only for geographic atrophy secondary to age‑related macular degeneration; non‑FDA uses and patients not meeting the policy criteria are excluded. Key requirements: approval for up to 12 months requires documented GA diagnosis and BCVA of ≥24 ETDRS letters or ≥20/320 Snellen, administration by or under the supervision of an ophthalmologist, documentation of dosing (15 mg intravitreal to each affected eye every 25–60 days), and adherence to the listed safety/coverage criteria.

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

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