Benralizumab (Fasenra)
EVICORE-MEDICAL_DRUG-AE7CD0BA
Benralizumab (Fasenra) is covered only as add‑on maintenance therapy for severe eosinophilic asthma in patients ≥12 years with a blood eosinophil count ≥150 cells/µL within 6 weeks, prescribed by or in consultation with an allergist/immunologist/pulmonologist; use in <12-year-olds or for off‑label indications is not covered. Key requirements: documentation of ≥3 months of prior ICS plus ≥1 additional controller (unless on anti‑IL‑5+ICS), evidence of uncontrolled asthma (≥2 steroid-requiring exacerbations or ≥1 ED/hospitalization in the prior year, or FEV1<80% predicted or FEV1/FVC<0.80, or OCS‑dependent worsening), adherence to dosing (30 mg SC q4wk ×3 then q8wk), initial approval for 6 months and reauthorization (12 months) requires ≥6 months of therapy and physician‑documented clinical response.
"Add-on maintenance treatment of individuals with severe asthma having an eosinophilic phenotype (FDA-approved indication)."