Histrelin acetate subcutaneous implant (Supprelin LA)

Supprelin LA (histrelin acetate 50 mg subcutaneous implant) is covered only for the FDA‑approved use: treatment of children with central precocious puberty and is not covered for non‑FDA‑approved indications. Coverage is limited to 12‑month approvals with required documentation of the diagnosis and that coverage criteria are met, and dosing is a 50 mg implant placed in the upper arm and replaced every 12 months.

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

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