Payer PolicyActive
Taliglucerase alfa (Elelyso)
EVICORE-MEDICAL_DRUG-C2364D97
EviCore by Evernorth
Effective: August 1, 2021
Updated: January 13, 2026
created · Dec 4, 2025
Policy Summary
Elelyso (taliglucerase alfa) is covered only for FDA‑approved treatment of Type 1 Gaucher disease (not for other indications) in patients aged ≥4 years. Approval (up to 1 year) requires documentation of deficient β‑glucocerebrosidase activity or a GBA gene mutation, prescription by or consultation with an appropriate specialist (geneticist, endocrinologist, metabolic disorder/lysosomal storage disorder specialist), and dosing limited to 60 U/kg IV no more frequently than every 2 weeks.
Coverage Criteria Preview
Key requirements from the full policy
"Elelyso is indicated for the treatment of individuals with Type 1 Gaucher disease."
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