Benlysta (belimumab)
EVICORE-MEDICAL_DRUG-28140075
Benlysta (IV belimumab) is covered for patients ≥5 years with active autoantibody‑positive SLE receiving concurrent standard therapy and for biopsy‑confirmed lupus nephritis in patients ≥5 when used with concurrent immunosuppressive therapy; not covered for patients <5 years. Initial approvals are limited (SLE 4 months, lupus nephritis 6 months) with 12‑month renewals requiring documented clinical response, specialist prescription/consultation, required lab/biopsy confirmation and medication documentation, and dosing per 10 mg/kg (weeks 0, 2, 4 then every 4 weeks).
"Patients aged 5 years and older with active systemic lupus erythematosus (SLE) who are receiving standard therapy."
Sign up to see full coverage criteria, indications, and limitations.