Plasminogen, Human-tvmh (Ryplazim®)

Ryplazim is covered only for FDA‑approved plasminogen deficiency type 1 (hypoplasminogenemia) and not for other indications. Coverage requires documented biallelic PLG mutations, a pre‑treatment plasminogen activity ≤45% of normal, a history of compatible lesions/symptoms, prescription by or in consultation with a hematologist, dosing 6.6 mg/kg IV no more often than every other day, initial approval for 3 months (renewable for 12 months) and reauthorization showing clinical response or an absolute trough plasminogen activity increase ≥10% over baseline.

"Ryplazim is indicated for the treatment of patients with plasminogen deficiency type 1 (hypoplasminogenemia)."

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