Payer PolicyActive
Velaglucerase alfa (Vpriv)
EVICORE-MEDICAL_DRUG-9663AE01
EviCore by Evernorth
Effective: September 1, 2019
Updated: January 13, 2026
created · Dec 4, 2025
Policy Summary
Vpriv (velaglucerase alfa) is covered only for the FDA‑approved indication of Type 1 Gaucher disease and no off‑label/compendial uses are approved. Approval requires documented β‑glucocerebrosidase deficiency or GBA gene mutation, prescription by or consultation with an appropriate specialist (geneticist, endocrinologist, metabolic/lysosomal disorder specialist), dosing of 60 U/kg IV no more frequently than every 2 weeks, a 1‑year authorization, and submission of lab/genetic results, prescriber specialty/consultation note, and clinical records.
Coverage Criteria Preview
Key requirements from the full policy
"Vpriv is indicated for the treatment of individuals with Type 1 Gaucher disease."
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