Leuprolide Acetate (Fensolvi)

Fensolvi (leuprolide acetate) is covered for central precocious puberty in pediatric patients ≥2 years and for compendial (off‑label) use in gender‑dysphoric/gender‑incongruent individuals or those undergoing gender reassignment, and other uses are not supported by this policy. Approval is for 12 months, limited to one 45 mg subcutaneous injection every 6 months, and requires documentation of the diagnosis/age or gender‑dysphoria/reassignment status, prescription by or consultation with an endocrinologist or a clinician specializing in transgender care, and satisfaction of the policy’s coverage and safety criteria.

"FDA‑approved: Treatment of pediatric patients 2 years of age and older with central precocious puberty (CPP)."

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