Onpattro® (patisiran)

Covered: Onpattro (patisiran) is covered only for adults (≥18) with polyneuropathy from hereditary transthyretin-mediated amyloidosis; other indications are excluded. Key requirements: documented pathogenic TTR variant on genetic testing, evidence of symptomatic polyneuropathy, prescription by or consultation with a neurologist/geneticist/amyloidosis specialist, IV administration every 3 weeks for up to 12 months with weight‑based dosing (0.3 mg/kg q3w if <100 kg; 30 mg q3w if ≥100 kg), and documentation of age and actual body weight.

"Onpattro is indicated for the treatment of polyneuropathy of hereditary transthyretin-mediated amyloidosis in adults."

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