Elaprase® (idursulfase)

Elaprase (idursulfase) is covered only for the FDA‑approved indication of mucopolysaccharidosis type II (Hunter syndrome) and is excluded for all other diagnoses. Coverage requires documented confirmation by deficient iduronate‑2‑sulfatase activity (leukocytes, fibroblasts, serum or plasma) or a pathogenic IDS gene variant, prescription by or consultation with a geneticist/endocrinologist/metabolic or lysosomal storage disorder specialist, adherence to the 0.5 mg/kg IV once‑weekly dosing, compliance with the policy’s safety/coverage criteria, and is authorized for up to 12 months.

"Elaprase (idursulfase) is indicated for the treatment of individuals with mucopolysaccharidosis type II (MPS II; Hunter syndrome)."

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