Actimmune (interferon gamma-1b)
EVICORE-MEDICAL_DRUG-F2FC3D2B
Actimmune (interferon gamma‑1b) is authorized only for its FDA‑approved uses—reducing infections in chronic granulomatous disease (CGD) and delaying progression of severe malignant osteopetrosis—and off‑label indications are not covered. Authorization requires indication‑specific documentation (molecular genetic confirmation for CGD; radiographic evidence or genetic testing for osteopetrosis), prescribing by or consultation with the required specialist (immunologist for CGD; endocrinologist for osteopetrosis), adherence to specified subcutaneous dosing, and is limited to 12 months per approval.
"Reducing the frequency and severity of serious infections associated with chronic granulomatous disease (CGD)."
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