Payer PolicyActive
Taliglucerase alfa (Elelyso)
EVICORE-MEDICAL_DRUG-D2FF64BE
EviCore by Evernorth
Effective: August 1, 2020
Updated: January 13, 2026
created · Dec 4, 2025
Policy Summary
Elelyso (taliglucerase alfa) is covered only for the FDA‑approved treatment of Type 1 Gaucher disease and is not supported for any other indications. Coverage requires documented deficient β‑glucocerebrosidase activity in leukocytes or fibroblasts OR molecular genetic confirmation of a GBA mutation, prescription by or in consultation with a geneticist, endocrinologist, metabolic disorder sub‑specialist or lysosomal storage disorder specialist, approval is for 1 year, and dosing is 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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