Eculizumab (Soliris)
EVICORE-MEDICAL_DRUG-DBD5A393
Soliris is covered only for its FDA‑approved indications—PNH, aHUS, anti‑AChR antibody‑positive generalized myasthenia gravis, and anti‑AQP4 antibody‑positive NMOSD—with exclusion of Shiga toxin E. coli–related HUS and only when indication‑specific criteria are met. Key requirements include diagnostic confirmation (PNH: peripheral flow cytometry; gMG: anti‑AChR; NMOSD: anti‑AQP4), age ≥18 for most indications, specialist prescribing/consultation (hematology, nephrology, or neurology), required prior therapies (e.g., pyridostigmine + two immunosuppressants for gMG; prior NMOSD agents or alternatives), adherence to dosing schedules, and documentation of clinical benefit for reauthorization.
"The treatment of patients with paroxysmal nocturnal hemoglobinuria (PNH) to reduce hemolysis."
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