Belimumab (Benlysta)

Covered: belimumab (Benlysta) for patients ≥5 years with active, autoantibody‑positive (ANA and/or anti‑dsDNA) systemic lupus erythematosus receiving standard therapy; excluded if not autoantibody‑positive or outside FDA‑approved indications. Key requirements: concurrent use of ≥1 standard SLE therapy (antimalarial, systemic corticosteroid, or other immunosuppressant) unless intolerant, prescribed/by consult with a rheumatologist, clinical immunologist, nephrologist, neurologist, or dermatologist, initial approval 4 months with 12‑month renewals contingent on documented clinical response and meeting safety criteria.

"Benlysta is indicated for the treatment of patients aged 5 years and older with active, autoantibody-positive, systemic lupus erythematosus (SLE) who are receiving standard therapy."

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