Natalizumab (Tysabri)

Covers natalizumab (Tysabri) only for FDA‑approved relapsing forms of multiple sclerosis (CIS, relapsing‑remitting, active secondary progressive) and moderately‑to‑severely active Crohn’s disease in adults (≥18). Coverage requires specialty prescribing/consultation (neurologist/MS specialist for MS; gastroenterologist for CD), prior‑therapy or disease‑activity criteria (failure/intolerance to one DMT or documentation of highly‑active MS for MS; trial of ≥2 biologics for CD), dosing limited to 300 mg IV every 4 weeks, documentation of clinical response for reauthorization, specified approval durations (MS 1 year; CD initial 3 months, reauthorization 1 year), and adherence to applicable safety monitoring.

"FDA-approved indications: Multiple Sclerosis"

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