Izervay™ (avacincaptad pegol intravitreal solution)

Izervay is covered only for geographic atrophy secondary to age-related macular degeneration and is not covered for other indications. Coverage requires BCVA in the affected eye between 20/25 and 20/320, administration by or under the supervision of an ophthalmologist, adherence to the labeled dose (2 mg/0.1 mL intravitreal monthly), documentation of diagnosis, BCVA, administration and treatment plan, and is approved for up to 12 months with applicable safety criteria met.

"Documentation that the drug will be or was "administered by or under the supervision of an ophthalmologist."

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