Inebilizumab-cdon (Uplizna®) Injection

Covers Uplizna (inebilizumab‑cdon) only for FDA‑approved AQP4‑antibody–positive NMOSD in adults (≥18) and excludes AQP4‑negative patients, pediatric use, and non‑FDA indications. Initial approval requires documented positive AQP4 test, prior trial of Soliris (eculizumab) or Enspryng (satralizumab) OR two of azathioprine/corticosteroid/mycophenolate/rituximab, plus ≥1 relapse in the past 12 months (or ≥2 in 2 years) and prescription by/consultation with a neurologist; reauthorization requires documented clinical benefit, authorization is for 12 months, and recommended dosing is 300 mg IV x2 (2 weeks apart) then every 6 months.

"Treatment of neuromyelitis optica spectrum disorder (NMOSD) in adult patients who are anti-aquaporin-4 antibody positive."

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