Elapegademase-lvlr (Revcovi)

Revcovi (elapegademase‑lvlr) is covered only for FDA‑approved treatment of ADA‑SCID in pediatric and adult patients and off‑label uses are not supported. Coverage requires confirmed ADA deficiency by molecular testing (bi‑allelic ADA mutations) or baseline ADA enzyme activity <1%, prescription by or consultation with an immunologist/hematologist/oncologist or ADA‑SCID specialist, intramuscular administration only, authorization limited to 12 months, and adherence to specified dosing (Adagen‑naïve: 0.4 mg/kg/week divided into two doses; transitioning: use conversion formula or default 0.2 mg/kg/week if prior Adagen dose unknown).

"Revcovi is a recombinant adenosine deaminase indicated for the treatment of adenosine deaminase severe combined immune deficiency (ADA-SCID) in pediatric and adult patients (FDA-approved indication)."

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