Eculizumab (Soliris)

Soliris (eculizumab) is covered for FDA‑approved PNH, aHUS, anti‑AChR antibody–positive generalized myasthenia gravis (adults), and AQP4‑antibody–positive NMOSD (adults) but excluded for Shiga toxin–related HUS; administration is IV only with indication‑specific induction/maintenance (pediatric weight‑based dosing for aHUS). Coverage requires diagnostic confirmation (PNH by peripheral blood flow cytometry; antibody tests for gMG/NMOSD; exclusion of Shiga‑toxin aHUS), age limits (generally ≥18 years except pediatric aHUS), specialist prescribing/consultation (hematology/nephrology for aHUS, hematology for PNH, neurology for gMG/NMOSD), specified prior therapy trials (e.g., pyridostigmine and two immunosuppressants for gMG; listed immunotherapies for NMOSD), and documentation of clinical benefit for reauthorization.

"The treatment of patients with paroxysmal nocturnal hemoglobinuria (PNH) to reduce hemolysis."