Subcutaneous Immune Globulins (Cuvitru, Hizentra, Hyqvia)

Subcutaneous immune globulins (Cutaquig, Cuvitru, Hizentra, Hyqvia, Xembify) are covered for FDA‑approved primary humoral immunodeficiencies and for maintenance therapy of CIDP (Hyqvia is limited to patients ≥18 and Hyqvia is excluded for CIDP). Coverage requires documentation of diagnosis and age, specialist prescribing/consultation (allergist/immunologist/ENT/pulmonologist/infectious disease for PID; neurologist for CIDP), laboratory evidence of hypogammaglobulinemia and/or impaired antibody response or recurrent infections (electrodiagnostic confirmation for CIDP), and demonstration of clinical benefit for 12‑month approvals.

"Primary humoral immunodeficiency (FDA-approved) including but not limited to congenital agammaglobulinemia, common variable immunodeficiency, x-linked agammaglobulinemia, Wiskott-Aldrich syndrome, ..."

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