Afamelanotide (Scenesse)

Scenesse (afamelanotide) is covered for adults (≥18) with erythropoietic protoporphyria (including X‑linked) to increase pain‑free light exposure, administered as a subcutaneous implant every 2 months for up to 12 months. Coverage requires diagnostic confirmation by elevated free erythrocyte protoporphyrin or molecular genetic testing, a history of ≥1 porphyric phototoxic reaction, prescription by or consultation with a dermatologist, gastroenterologist, hepatologist, or porphyria specialist, and is limited to the FDA‑approved indication (not covered if these criteria or the age requirement are not met).

"Scenesse is indicated to increase pain free light exposure in adult patients with a history of phototoxic reactions from erythropoietic protoporphyria (EPP)."

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