Lumasiran (Oxlumo)

Oxlumo (lumasiran) is covered for PH1 to lower urinary oxalate in pediatric and adult patients but is not covered for patients who have had a liver transplant for PH1. Coverage requires AGXT genetic confirmation, documented elevated urinary oxalate (≥0.7 mmol/24 h/1.73 m² or urine oxalate:creatinine > age‑specific ULN), prescription by or in consultation with a nephrologist or urologist, initial approval for 6 months (dosing: 6 mg/kg SC monthly ×3 then maintenance 3 mg/kg SC monthly or 6 mg/kg SC every 3 months), and renewals (12 months) require objective evidence of benefit within the past 6 months.

"Prescriber limitation: medication must be prescribed by or in consultation with a nephrologist or urologist."

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