Leuprolide Acetate (Fensolvi®, Lupron Depot- PED®, Lupron Depot®)

Leuprolide acetate (Fensolvi, Lupron Depot‑PED, Lupron Depot) is covered for non‑oncology uses: Fensolvi and Lupron Depot‑PED for central precocious puberty (Fensolvi ≥2 years; Lupron Depot‑PED limited to children), Lupron Depot for endometriosis, uterine leiomyomata (including preoperative anemia with concomitant iron), abnormal uterine bleeding (Lupron Depot only), and compendial gender‑dysphoria/gender‑incongruence uses; oncology indications are excluded. Coverage requires documentation of the diagnosis and age, prescriber/consultation by an endocrinologist or transgender‑care specialist for gender‑related uses, prior‑therapy trial(s) for Lupron Depot unless contraindicated (contraceptive, oral progesterone, DMPA, other GnRH agonist or antagonist), and adherence to specified approval durations (12 months for Fensolvi/Lupron‑PED; Lupron Depot: 3 months for fibroids, 6 months for abnormal uterine bleeding, 12 months for other indications).

"Fensolvi is indicated for the treatment of pediatric patients 2 years of age and older with central precocious puberty (CPP)."