Tezspire® (tezepelumab-ekko)

Covered: Tezspire (tezepelumab-ekko) is authorized as add‑on maintenance therapy for severe asthma in patients ≥12 years when used per FDA indication; it is not covered for patients <12 years or when the policy criteria/FDA indication are not met. Key requirements: initial approval requires ≥3 months of an inhaled corticosteroid plus another controller, documented uncontrolled asthma (≥2 systemic‑steroid treated exacerbations in the prior year, or ≥1 hospitalization/ER/urgent care visit, or FEV1 <80% predicted, or FEV1/FVC <0.80, or worsening on oral steroid taper), prescription by/with an allergist/immunologist/pulmonologist, dosing 210 mg SC every 4 weeks, initial approval for 6 months; reauthorization requires ≥6 months of Tezspire, continued ICS therapy and documented clinical response (renewal 12 months).

"Tezspire is indicated for the add-on maintenance treatment of adult and pediatric patients aged 12 years and older with severe asthma."