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

Covers Aralast NP, Glassia, Prolastin‑C, and Zemaira for chronic augmentation/maintenance in adults with clinically evident emphysema due to severe congenital AAT deficiency and for panniculitis (compendial use), but excludes patients <18 years, current smokers, or those with baseline AAT ≥11 µmol/L (≥80 mg/dL). Authorization (up to 12 months) requires age ≥18, documentation of diagnosis, baseline AAT <11 µmol/L for emphysema, nonsmoking status, and a medication order consistent with the recommended 60 mg/kg IV weekly dosing.

"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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