Reblozyl® (luspatercept-aamt)

Reblozyl is covered for anemia in adults (≥18) with transfusion‑dependent beta‑thalassemia who received ≥6 units RBCs in the prior 24 weeks and had no transfusion‑free interval >35 days, and is excluded for patients who previously received gene therapy for transfusion‑dependent beta‑thalassemia (e.g., Zynteglo, Casgevy). Key requirements: prescribed by or in consultation with a hematologist; initial approval 4 months (renewal 12 months) requires documented ≥2‑unit reduction in transfusion burden over 6 months versus baseline; dosing 1 mg/kg SC every 3 weeks (may increase to 1.25 mg/kg); and submission of age, transfusion records, prescriber specialty, and prior‑therapy documentation.

"Approval duration limits: Initial approval duration is 4 months; Renewal approval duration is 12 months."

Sign up to see full coverage criteria, indications, and limitations.