Revcovi™ (elapegademase-lvlr)

Revcovi is covered only for pediatric and adult ADA‑SCID and is excluded for other diagnoses or if required diagnostic confirmation or specialist involvement is missing. Coverage requires molecular confirmation of bi‑allelic ADA mutations or absent/very low (<1%) ADA activity, prescription/consultation with an immunologist/hematologist/oncologist or ADA‑SCID specialist, documentation of weight and prior Adagen dose (or that it’s unknown) to apply specific dosing/conversion rules (Adagen‑naïve start 0.4 mg/kg/week split as 0.2 mg/kg twice weekly for at least 12–24 weeks until immune reconstitution; transitioning patients start 0.2 mg/kg/week if Adagen ≤30 U/kg or unknown or an equivalent converted dose if Adagen >30 U/kg), and authorization is granted for 12 months with required clinical documentation for reauthorization.

"Revcovi is a recombinant adenosine deaminase indicated for the treatment of adenosine deaminase severe combined immune deficiency (ADA-SCID) in pediatric and adult patients."