Skysona (elivaldogene autotemcel) - Medicare Advantage

This policy covers Skysona (elivaldogene autotemcel), a one-time autologous lentiviral gene therapy for cerebral adrenoleukodystrophy (CALD). Coverage is limited to males age 4–17 with early, active (asymptomatic or mildly symptomatic) CALD meeting MRI gadolinium enhancement with Loes score 0.5–9 and NFS ≤1, who lack an available HLA‑matched donor, and requires pre‑treatment infection screening (HBV/HCV/HIV/HTLV), Medicare reasonable‑and‑necessary determination, and prior review/authorization (medical director/Corporate Transplant Department); single lifetime administration only.

"No Related Medicare Advantage Medical/Pharmacy Coverage Policies listed (None)."

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