Payer PolicyActive
Coagulation Factor VIIa (recombinant)-jncw [Sevenfact]
EVICORE-MEDICAL_DRUG-87838983
EviCore by Evernorth
Effective: February 1, 2021
Updated: January 13, 2026
created · Dec 4, 2025
Policy Summary
Sevenfact is covered for treatment and control of bleeding episodes in patients ≥12 years with hemophilia A or B with inhibitors only for FDA‑approved indications (non‑FDA indications excluded) and is for intravenous use only. Approval requires documentation of the FDA‑approved diagnosis and that applicable coverage/safety criteria are met, with initial authorization for 3 months and renewals for 12 months.
Coverage Criteria Preview
Key requirements from the full policy
"Sevenfact is a coagulation factor VIIa concentrate indicated for the treatment and control of bleeding episodes occurring in adults and adolescents (12 years of age and older) with hemophilia A or ..."
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