Reblozyl® (luspatercept-aamt)
EVICORE-MEDICAL_DRUG-71419939
EviCore covers Reblozyl for adults (≥18) with beta thalassemia who require regular RBC transfusions and excludes pediatric patients, non‑FDA indications (outside the approved non‑oncology use) and those with prior Zynteglo. Initial approval (4 months) requires documentation of ≥6 units RBCs in the prior 24 weeks with no transfusion‑free period >35 days, hematologist prescribing/consultation, age/diagnosis/transfusion history/no prior Zynteglo and dosing per policy (start 1 mg/kg SC q3 weeks, may increase to 1.25 mg/kg); renewal (12 months) requires a ≥2‑unit reduction in transfusion burden over 6 months.
"Has not received Zynteglo (betibeglogene autotemcel) in the past."
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