C1 Esterase Inhibitor (Ruconest)

Ruconest is covered only for treatment of acute hereditary angioedema attacks due to C1‑INH deficiency (Type I or II) and is not covered for prophylaxis or HAE with normal C1‑INH. Coverage requires baseline labs documenting functional C1‑INH <50% and low serum C4, prescription by or in consultation with an allergist/immunologist or HAE specialist, 12‑month approvals with reauthorization requiring prior Ruconest use and documented favorable clinical response, and dosing limited to 50 IU/kg (max 4,200 IU) IV no more than twice daily.

"Ruconest is indicated for the treatment of acute attacks of Hereditary Angioedema (HAE)."

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