Nulojix® (belatacept)

Covered: Nulojix is authorized for prophylaxis of organ rejection in adult (≥18) kidney transplant recipients (FDA‑approved) and only for continuation (not initiation) in other solid‑organ transplant patients currently receiving Nulojix; pediatric patients, EBV‑seronegative/unknown patients, and de novo non‑kidney starts are excluded. Key requirements: patient must be EBV‑seropositive, prescribed by or in consultation with a transplant specialist, kidney use must be given with basiliximab induction + mycophenolate mofetil + corticosteroids, IV weight‑based dosing (dose changes only if weight changes >10%), with documentation of EBV serology, transplant details, weight and infusion records (non‑kidney approvals limited to 12 months).

"Infusion administration records (IV infusion documentation) and dosing schedule consistent with weight-based regimen."

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