Crovalimab-akkz

Crovalimab‑akkz (Piasky) is covered for treatment of paroxysmal nocturnal hemoglobinuria (PNH) to reduce hemolysis in patients aged ≥13 years and weighing ≥40 kg, primarily evaluated in complement‑inhibitor–naïve patients with LDH ≥2×ULN and PNH‑related signs or symptoms. Coverage is limited to FDA‑approved dosing and indications (including the specified IV loading and SC maintenance regimen), requires Neisseria meningitidis vaccination and enrollment in the Piasky REMS, excludes use in patients <13 years or <40 kg and concurrent use with other PNH biologics, and is subject to member benefit, state (Ohio), and compendia restrictions.

"Therapies are covered when proven effective for the relevant diagnosis according to generally accepted standards of practice."

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