Scenesse® (afamelanotide)

Scenesse (afamelanotide) is covered for adults (≥18 years) with erythropoietic protoporphyria (including X‑linked) to increase pain‑free light exposure; uses outside this FDA‑approved indication are not covered. Coverage requires diagnostic confirmation by elevated free erythrocyte protoporphyrin or molecular genetic testing, a history of ≥1 porphyric phototoxic reaction, prescription by or consultation with a dermatologist/gastroenterologist/hepatologist/porphyria specialist, administration as a subcutaneous implant every 2 months, and is authorized for up to 12 months (with documentation for renewal).

"Scenesse is indicated to increase pain free light exposure in adult patients with a history of phototoxic reactions from erythropoietic protoporphyria (EPP)."

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