Interferon Gamma-1b (Actimmune®)

Actimmune (interferon gamma‑1b) is covered only for the two FDA‑approved indications—reducing serious infections in chronic granulomatous disease (CGD) and delaying progression of severe malignant osteopetrosis—and non‑FDA uses are excluded; approval is for 12 months with subcutaneous dosing three times weekly per BSA/weight limits. Coverage requires diagnostic documentation (CGD: molecular genetic test; osteopetrosis: radiographic evidence or molecular genetic test), prescription by or consultation with an immunologist (CGD) or endocrinologist (osteopetrosis), and meeting applicable safety and dosing documentation criteria.

"Reducing the frequency and severity of serious infections associated with chronic granulomatous disease (CGD)"

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