Teprotumumab-trbw (Tepezza)
EVICORE-MEDICAL_DRUG-191A3CD2
Tepezza (teprotumumab‑trbw) is covered for the FDA‑approved indication of thyroid eye disease (including Graves' ophthalmopathy/orbitopathy) in adults ≥18 with active, at least moderate disease, and is not covered for patients <18, for inactive or mild disease, non‑FDA indications, or after a patient has already received 8 total doses. Approval is limited to a 6‑month authorization with dosing per the 8‑infusion regimen (10 mg/kg IV once then 20 mg/kg IV every 3 weeks ×7), must be prescribed by or in consultation with an ophthalmologist, endocrinologist, or thyroid‑eye disease specialist, and requires documentation of diagnosis, disease activity/severity, age, specialist involvement, prior Tepezza doses, and infusion records.
"Tepezza is indicated for the treatment of thyroid eye disease."
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