Berinert® (C1 esterase inhibitor [human])
EVICORE-MEDICAL_DRUG-E546E49A
Berinert is covered for treatment of acute HAE attacks and compendial prophylaxis only for patients with HAE type I or II due to C1‑INH deficiency, and is excluded for other diagnoses or HAE without documented C1‑INH deficiency/C4 abnormalities. Coverage requires baseline labs showing functional C1‑INH <50% of normal and low serum C4, prescription by or consultation with an allergist/immunologist or HAE specialist, dosing 20 IU/kg IV no more than once daily, 12‑month authorizations, and reauthorization with documented clinical benefit (e.g., reduced attack frequency/severity/duration or rapid symptom relief).
"Berinert is indicated for the treatment of acute attacks of Hereditary Angioedema (HAE)."
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