Payer PolicyActive
Cerezyme® (imiglucerase)
EVICORE-MEDICAL_DRUG-677251C0
EviCore by Evernorth
Effective: May 1, 2024
Updated: January 13, 2026
created · Dec 4, 2025
Policy Summary
Cerezyme (imiglucerase) is covered only for Type 1 Gaucher disease (other Gaucher types or non‑Gaucher diagnoses are not covered). Coverage requires documentation of deficient β‑glucocerebrosidase activity in leukocytes or fibroblasts OR molecular genetic confirmation of a GBA mutation, prescription by or in consultation with a geneticist, endocrinologist, metabolic disorder subspecialist, or lysosomal storage disorder specialist, a treatment plan consistent with 60 U/kg IV every other week, and is approved for up to 1 year.
Coverage Criteria Preview
Key requirements from the full policy
"Cerezyme is indicated for the treatment of individuals with Type 1 Gaucher disease."
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