Imiglucerase (Cerezyme)
EVICORE-MEDICAL_DRUG-B5BC67E0
Cerezyme (imiglucerase) is covered only for the FDA‑approved indication of Type 1 Gaucher disease and is not covered for non–Type 1 or off‑label uses. Coverage requires diagnostic confirmation by deficient β‑glucocerebrosidase activity in leukocytes/fibroblasts or molecular genetic testing, prescription by or consultation with a geneticist, endocrinologist, metabolic disorder or lysosomal storage disorder specialist, a 1‑year authorization, dosing limited to 60 U/kg IV no more frequently than every 2 weeks, and meeting applicable safety criteria with supporting documentation.
"Cerezyme is indicated for the treatment of individuals with Type 1 Gaucher disease."
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