Mepolizumab (Nucala®)

Covers mepolizumab (Nucala) only for its FDA‑approved uses—add‑on maintenance for severe eosinophilic asthma (≥6 years), EGPA (adults), HES (≥12 years, ≥6 months, FIP1L1‑PDGFRα‑negative) and chronic rhinosinusitis with nasal polyps (adults)—and is excluded if the detailed clinical, laboratory, prior‑therapy, age, or specialist requirements are not met. Key requirements include blood eosinophil thresholds (≥150 cells/µL for asthma and EGPA; ≥1,000 cells/µL for HES), specified prior therapy trials (≥3 months ICS+controller for asthma; ≥4 weeks corticosteroids for EGPA; ≥4 weeks of other HES treatments), prescriber/specialist or consultation requirements, objective documentation of disease and response for reauthorization, initial authorization limits (6 months for most indications; 8 months for HES) and typically 12‑month reauthorizations.

"Severe asthma: Requires at least 3 consecutive months of combination therapy with an inhaled corticosteroid and one additional asthma controller/maintenance medication prior to Nucala."