Ocrelizumab (Ocrevus)

Ocrevus is covered for adults (≥18) with FDA‑approved relapsing forms of MS (including CIS, relapsing‑remitting, active secondary progressive) or primary progressive MS when prescribed by or in consultation with an MS specialist/neurologist; use in patients <18 or for non‑FDA indications is excluded. Initial approval for relapsing MS requires prior inadequate efficacy or intolerance to at least one disease‑modifying therapy plus documentation of diagnosis and specialist prescriber, dosing per label (300 mg IV ×2 two weeks apart, then 600 mg IV every 6 months), approvals are for 12 months, and reauthorization after ≥1 year requires objective clinical benefit or symptom stabilization.

"When requesting Ocrevus (ocrelizumab), the individual requiring treatment must be diagnosed with an FDA-approved indication and meet the specific coverage guidelines and applicable safety criteria ..."