Ravulizumab-cwvz

Covers ravulizumab-cwvz (Ultomiris) for treatment of complement-mediated disorders—including paroxysmal nocturnal hemoglobinuria (PNH, in patients ≥1 month), atypical hemolytic uremic syndrome (aHUS), generalized myasthenia gravis (gMG) in adults (AChR‑antibody positive with prior trial/intolerance to acetylcholinesterase inhibitor and ≥1 immunosuppressant), and anti‑AQP4 antibody–positive neuromyelitis optica spectrum disorder (NMOSD) in adults. Coverage is limited to HCSC members in Ohio and is governed by the member’s benefit plan; off‑label uses require compendia or ≥2 peer‑reviewed articles, vaccination against Neisseria meningitidis (or clinical justification), and the drug must not be used concurrently with other biologics for the same indication.

"Coverage determinations are governed by the member's benefit plan, summary plan description, or contract."