Enjaymo® (sutimlimab-jome)

Enjaymo (sutimlimab‑jome) is covered only for treatment of hemolysis in adults with cold agglutinin disease and is not covered for patients who do not meet the policy’s strict diagnostic, laboratory, and prescriber criteria. Coverage requires age ≥18, weight ≥39 kg, ≥1 CAD symptom, evidence of chronic hemolysis with a DAT strongly positive for C3d and negative/weak IgG, cold agglutinin titer ≥64 at 4°C, baseline hemoglobin ≤10 g/dL and elevated total bilirubin, exclusion of secondary causes, hematologist prescribing/consultation, approval limited to 12 months, and specified weight‑based IV dosing (≥75 kg: 7,500 mg weekly ×2 then q2w; 39–<75 kg: 6,500 mg weekly ×2 then q2w).

"Enjaymo is indicated for the treatment of hemolysis in adults with cold agglutinin disease."

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