Pasireotide injection (Signifor LAR)

Signifor LAR is covered only for FDA‑approved acromegaly and Cushing’s disease indications and for compendial off‑label Cushing’s uses (patients awaiting surgery or awaiting radiotherapy response); other uses are excluded. Coverage requires endocrinologist/Cushing‑specialist prescribing or consultation, documentation of diagnosis/prior treatments and response, baseline and follow‑up labs (pre‑treatment IGF‑1 for acromegaly; 24‑hour/mean urinary free cortisol for Cushing’s), adherence to specified dose/initiation and escalation limits, compliance with safety criteria, and approval durations of 4 months for awaiting‑surgery/post‑radiotherapy Cushing’s and 12 months for other uses.

"Acromegaly: treatment of patients who have had an inadequate response to surgery and/or for whom surgery is not an option (FDA-approved)."

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