Nulibry® (fosdenopterin)

Nulibry (fosdenopterin) is covered only to reduce mortality in patients with molybdenum cofactor deficiency (MoCD) Type A and is excluded for other diagnoses or MoCD types. Coverage requires genetic confirmation of biallelic pathogenic/likely pathogenic MOCS1 variants for up to 12 months (or supportive laboratory findings with genetic testing in progress for an initial 1‑month authorization), documentation the patient is likely to benefit and disease is not too advanced, prescription by or consultation with a pediatrician/geneticist/MoCD specialist, and adherence to age/weight‑based IV dosing per the label.

"Reduce the risk of mortality in patients with molybdenum cofactor deficiency (MoCD) Type A (FDA‑approved indication)."

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