Histrelin acetate subcutaneous implant (Supprelin® LA)

Supprelin LA (histrelin acetate 50 mg subcutaneous implant) is covered only for the FDA‑approved indication of central precocious puberty in children and is not covered for non‑FDA or adult uses. Approval is limited to 12 months with a frequency limit of one 50 mg implant placed subcutaneously in the upper arm every 12 months and requires documentation of the diagnosis and that the request meets the coverage guidelines.

"Treatment of children with central precocious puberty (FDA-approved indication)."

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