Alemtuzumab (Lemtrada)

Alemtuzumab (Lemtrada) is covered for relapsing forms of MS in patients ≥17 when prescribed by or in consultation with an MS specialist, with initial approval for a 12 mg/day IV 5‑day course for those who have failed or are intolerant to two disease‑modifying therapies or who have highly‑active/aggressive disease, and reauthorization limited to a 12 mg/day IV 3‑day course only if ≥12 months have elapsed since the prior Lemtrada course. Key requirements: documentation of diagnosis, age, specialist prescriber/consult, prior DMT trial history or clinical/MRI evidence of highly‑active disease, dosing plan, and dates of prior Lemtrada doses; use for patients <17 or other indications is not covered.

"Treatment of relapsing forms of multiple sclerosis (MS)."

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