Belimumab (Benlysta)

Benlysta (belimumab) is covered only for adults (≥18) with active, autoantibody‑positive SLE receiving standard therapy; no off‑label/compendial uses are approved. Coverage requires specialist prescribing/consultation, documentation of positive ANA and/or anti‑dsDNA, concurrent standard SLE therapy (or documented intolerance), IV dosing 10 mg/kg at weeks 0, 2, and 4 then every 4 weeks, initial approval for 4 months and 12‑month reauthorization only with documented clinical response.

"Treatment of an adult with active, autoantibody-positive systemic lupus erythematosus (SLE) who is receiving standard therapy (FDA‑approved indication)."

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