Velaglucerasa alfa (VPRIV)

Velaglucerase alfa (VPRIV) is covered only for FDA‑approved Type 1 Gaucher disease (not other Gaucher types) when diagnosis is documented by deficient β‑glucocerebrosidase activity or GBA gene mutation and therapy is prescribed by or in consultation with a geneticist, endocrinologist, metabolic disorder subspecialist, or lysosomal storage disorder specialist. Coverage is limited to 60 U/kg IV no more frequently than every 2 weeks, approved for 1 year, and requires documentation of diagnostic test results, specialist prescribing/consultation notes, and dosing/safety records.

"Treatment of individuals with Type 1 Gaucher disease (FDA-approved indication)."

Sign up to see full coverage criteria, indications, and limitations.