Adakveo (crizanlizumab-tmca)

Adakveo (crizanlizumab‑tmca) is covered only for its FDA‑approved use to reduce vaso‑occlusive crises in patients with sickle cell disease aged ≥16 who have had ≥1 sickle‑cell–related crisis in the prior 12 months (patients <16 or non‑FDA indications are excluded). Coverage requires documentation of diagnosis and the prior crisis, that the patient is either on hydroxyurea or has inadequate response/intolerance or is not a candidate for hydroxyurea (e.g., pregnancy, immunosuppression), prescription by or in consultation with a sickle‑cell specialist (eg, hematologist), adherence to the recommended dosing schedule, and yearly reauthorization with evidence of clinical benefit; approvals are for 12 months.

"Adakveo is indicated to reduce the frequency of vaso-occlusive crises (VOCs) in adults and pediatric patients aged 16 years and older with sickle cell disease."