Adzynma (ADAMTS13, Recombinant-Krhn) – Commercial Medical Benefit Drug Policyopen_in_new

This policy covers Adzynma (ADAMTS13, recombinant‑krhn) for routine prophylactic enzyme replacement to prevent TTP events and for on‑demand treatment of acute TTP episodes in patients with congenital thrombotic thrombocytopenic purpura (cTTP). Coverage requires molecular genetic confirmation of an ADAMTS13 mutation, dosing per FDA labeling, prescription by or in consultation with a hematologist, documentation of prior clinical response for continuation, and time‑limited authorization per the policy.

"Adzynma (ADAMTS13, recombinant-krhn) is proven and medically necessary for prophylactic treatment of congenital thrombotic thrombocytopenic purpura (cTTP) in patients who meet all of the following ..."

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