FcRn Blockers (Rystiggo®, Vyvgart®, & Vyvgart® Hytrulo) – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers Rystiggo (IV), Vyvgart (IV) and Vyvgart Hytrulo (SC) for their FDA‑indicated adult uses (gMG — Rystiggo for anti‑AChR or anti‑MuSK seropositive; Vyvgart/Vyvgart Hytrulo only for anti‑AChR gMG; Vyvgart Hytrulo also for CIDP) and excludes use in combination with complement inhibitors, other FcRn blockers or IVIG and off‑label indications. Coverage requires neurologist involvement, FDA‑labeled dosing, documented antibody positivity and disease severity (MGFA II–IV with MG‑ADL ≥5 for gMG; EFNS/PNS electrodiagnostics plus prior corticosteroid and IVIG trials for CIDP), specified prior therapy failures, objective clinical benefit for continuation (≥2‑point MG‑ADL improvement or validated CIDP scale improvement), specified timing/limits (e.g., Rystiggo ≥63 days between cycles), and submission of supporting medical records.

"Rystiggo-specific: Diagnosis of gMG and positive serologic test for anti-AChR OR anti-MuSK antibodies required."