Alpha-1 Proteinase Inhibitor (Aralast NP, Glassia, Prolastin-C, Zemaira)

Policy authorizes Aralast NP, Glassia, Prolastin‑C, and Zemaira for chronic augmentation/maintenance in adults with clinically evident emphysema due to severe congenital AAT deficiency and, as a compendial use, for AAT‑deficiency panniculitis; non‑FDA/non‑compendial uses are not covered. Key requirements: patients must be ≥18 years, have baseline AAT <11 µmol/L (or <80 mg/dL by radial immunodiffusion or <57 mg/dL by nephelometry), be a current nonsmoker for emphysema, provide documented diagnosis/labs, with approval for 12 months and recommended dosing 60 mg/kg IV weekly.

"Chronic augmentation and maintenance therapy in adults with clinically evident emphysema due to severe congenital deficiency of alpha-1-antitrypsin (AAT) deficiency."

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