Belimumab (Benlysta)

Benlysta is covered only for FDA‑approved uses: active, autoantibody‑positive SLE in patients ≥5 years receiving standard therapy and active lupus nephritis in patients ≥18 years receiving standard therapy; non‑FDA indications are not covered. Coverage requires documented ANA and/or anti‑dsDNA positivity, concurrent use of ≥1 standard therapy unless intolerant, prescription/consultation by an appropriate specialist, objective clinical response for reauthorization, and adherence to specified age, dosing and approval‑duration limits.

"Benlysta is indicated for the treatment of patients aged 5 years and older with active, autoantibody-positive, systemic lupus erythematosus (SLE) who are receiving standard therapy."

Sign up to see full coverage criteria, indications, and limitations.