Payer PolicyActive
Apomorphine (Apokyn®)
EVICORE-MEDICAL_DRUG-10B9FCB1
EviCore by Evernorth
Effective: September 1, 2021
Updated: January 13, 2026
created · Dec 4, 2025
Policy Summary
Apokyn (apomorphine) is covered only for the FDA‑approved acute, intermittent treatment of hypomobility "off" episodes in advanced Parkinson’s disease and not for off‑label uses. Approval (up to 12 months) requires current carbidopa/levodopa therapy, documentation of intolerance or inadequate response to at least one other "off" therapy, neurologist prescribing or consult, subcutaneous administration with titration from 2 mg up to 6 mg, and documentation of diagnosis and applicable safety criteria.
Coverage Criteria Preview
Key requirements from the full policy
"Apokyn (apomorphine) is indicated for the acute, intermittent treatment of hypomobility "off" episodes ("end-of-dose wearing off" and unpredictable "on/off" episodes) with advanced Parkinson's dise..."
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