Payer PolicyActive
Apomorphine (Apokyn®)
EVICORE-MEDICAL_DRUG-F4BF46D2
EviCore by Evernorth
Effective: August 1, 2022
Updated: January 13, 2026
created · Dec 4, 2025
Policy Summary
Covered only for the FDA‑approved indication: acute, intermittent treatment of "off" episodes in advanced Parkinson's disease (non‑FDA uses are excluded). Coverage requires current carbidopa/levodopa therapy, documented intolerance or inadequate response to at least one other "off" therapy, prescription by or in consultation with a neurologist, subcutaneous administration with dosing starting at 0.2 mL (2 mg) titratable to 0.6 mL (6 mg), and documentation for up to 12 months.
Coverage Criteria Preview
Key requirements from the full policy
"Apokyn® (apomorphine) is indicated for the acute, intermittent treatment of hypomobility "off" episodes ("end-of-dose wearing off" and unpredictable "on/off" episodes) with advanced Parkinson's dis..."
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