Histrelin acetate subcutaneous implant (Supprelin LA)

Supprelin LA (histrelin acetate 50 mg subcutaneous implant) is covered only for the FDA‑approved use—treatment of children with central precocious puberty—and non‑FDA/off‑label indications are excluded. Coverage requires documentation confirming the diagnosis and implant placement (50 mg implanted subcutaneously in the upper arm), with approval limited to 12 months per authorization and dosing repeated every 12 months for renewal.

"Supprelin® LA (histrelin acetate subcutaneous implant) is indicated for the treatment of children with central precocious puberty."

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