Tzield™ (teplizumab-mzwv intravenous infusion)

Tzield is covered to delay onset of Stage 3 T1D in patients ≥8 years with Stage 2 (preclinical) T1D and is excluded for patients <8 years, those with clinical (Stage 3) T1D or type 2 diabetes, prior Tzield exposure, or active/chronic/EBV/CMV infections. Coverage requires an endocrinologist prescription, documentation of ≥1 biological relative with T1D, at least two specified T1D autoantibodies positive on two occasions, an OGTT within 2 months showing prespecified dysglycemia, baseline labs within limits (lymphocytes ≥1,000/mcL; Hgb ≥10 g/dL; platelets ≥150,000/mcL; ANC ≥1,500/mcL; ALT/AST ≤2×ULN; bilirubin ≤1.5×ULN), and is limited to one BSA‑based 14‑day course.

"Has not received Tzield in the past."

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