Alglucosidase Alfa (Lumizyme®)

Alglucosidase alfa (Lumizyme) is covered only for FDA‑approved treatment of Pompe disease and is not covered if required diagnostic confirmation, specialist prescribing/consultation, or applicable safety criteria are not met. Coverage requires documented deficient acid α‑glucosidase activity (blood, fibroblast, or muscle) or a GAA gene mutation, prescription by or consultation with a geneticist, neurologist, metabolic/lysosomal storage disorder specialist, dosing up to 20 mg/kg IV no more frequently than every 2 weeks, and authorization limited to 12 months.

"Treatment of individuals with Pompe disease (acid α‑glucosidase deficiency) — FDA‑approved indication"

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