Tezepelumab-ekko (Tezspire®)

Tezspire (tezepelumab‑ekko) is covered as an add‑on maintenance treatment for severe asthma in patients ≥12 years only when the FDA indication and all eviCore initial/reauthorization criteria are met; it is not covered if those criteria are not satisfied. Key requirements: documentation of ≥3 consecutive months of specified prior controller therapy (ICS plus another controller or an ICS/LABA combination inhaler with evidence of uncontrolled asthma by exacerbations, hospitalization/ED visit, FEV1/FVC or FEV1 criteria, or steroid‑taper worsening), prescribing or consultation by an allergist/immunologist/pulmonologist, initial approval for 6 months (210 mg SC every 4 weeks), reauthorization after ≥6 months with continued ICS use and objective clinical response for 12‑month renewals.

"Tezspire is indicated for the add-on maintenance treatment of adult and pediatric patients aged 12 years and older with severe asthma."