Natalizumab (Tysabri)

Natalizumab (Tysabri) is covered only for its FDA‑approved indications—relapsing multiple sclerosis and moderately‑to‑severely active Crohn’s disease—in patients aged ≥18 (non‑FDA indications and patients <18 are excluded). Coverage requires specialty prescriber involvement (neurologist/MS specialist for MS; gastroenterologist for CD), documented diagnosis and dosing (300 mg IV every 4 weeks), prior‑therapy criteria (MS: inadequate response/intolerance to ≥1 MS DMT or evidence of highly‑active/aggressive MS; CD: trial of ≥2 biologics), and documentation of clinical response for reauthorization; approval periods are typically 1 year for MS and 3 months initial/1 year reauthorization for CD.

"FDA-approved indications: Multiple Sclerosis"

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