Fosdenopterin (Nulibry®)

Fosdenopterin (Nulibry) is covered only to reduce mortality in patients with molybdenum cofactor deficiency (MoCD) Type A and is not covered for other MoCD types or other indications. Coverage requires genetic confirmation of a MOCS1 mutation, clinical documentation that the disease is not too advanced and the patient is expected to benefit, prescription or consultation by a pediatrician/geneticist/MoCD specialist, dosing up to 0.9 mg/kg IV once daily, and authorization for up to 12 months.

"Reduce the risk of mortality in patients with molybdenum cofactor deficiency (MoCD) Type A (FDA-approved indication)."

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