Alglucosidase Alfa (Lumizyme®)

Covered: Lumizyme (alglucosidase alfa) for the FDA‑approved treatment of Pompe disease only (off‑label uses excluded). Approval (up to 12 months) requires confirmed diagnosis by deficient acid α‑glucosidase activity or GAA genetic testing, prescription by or consultation with an appropriate specialist (geneticist, neurologist, metabolic disorder sub‑specialist or lysosomal storage disorders physician), dosing up to 20 mg/kg IV no more frequently than every 2 weeks, and meeting applicable safety/documentation criteria.

"Lumizyme (alglucosidase alfa) is indicated for the treatment of individuals with Pompe disease (acid α-glucosidase deficiency)."

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