Scenesse® (afamelanotide)

Scenesse (afamelanotide) is covered to increase pain‑free light exposure in adults (≥18) with erythropoietic protoporphyria (including X‑linked) and is not covered for patients who do not meet the policy criteria or are under 18. Coverage requires documented diagnosis by elevated free erythrocyte protoporphyrin or molecular genetic testing, a history of at least one porphyric phototoxic reaction, prescribing/consultation by a dermatologist, gastroenterologist, hepatologist or porphyria specialist, and supports a subcutaneous implant every 2 months with authorization for 12 months.

"Scenesse is indicated to increase pain free light exposure in adult patients with a history of phototoxic reactions from erythropoietic protoporphyria (EPP)."

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