Pasireotide injection (Signifor LAR)

Signifor LAR (pasireotide) is covered for FDA‑approved acromegaly (after inadequate response to or not a candidate for surgery/radiotherapy) and Cushing’s disease (when surgery is not an option or not curative), plus compendial off‑label use for Cushing’s patients awaiting surgery or awaiting radiotherapy response; other uses are not covered. Coverage requires endocrinologist/Cushing specialist prescribing or consultation, specified baseline and follow‑up labs (e.g., IGF‑1/GH for acromegaly, 24‑hr urinary free cortisol for Cushing’s), adherence to initial/max dosing and escalation timing (acromegaly: start 40 mg IM q28d, can increase to 60 mg after 3 months; Cushing’s: start 10 mg IM q28d, can increase to 40 mg after 4 months), documentation of clinical/lab response for renewals, and specified approval durations (acromegaly initial/renewal 3/12 months; Cushing’s and off‑label awaiting uses initial/renewal 4/12 months).

"Cushing's Disease/Syndrome - Patients Awaiting Surgery (approved off-label compendial use)."