Lemtrada® (Alemtuzumab) – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers Lemtrada (alemtuzumab) for relapsing forms of MS (e.g., RRMS, active SPMS) but excludes listed non‑MS autoimmune indications, only when criteria are met: treatment‑naïve patients must have failed or been intolerant to ≥2 listed MS DMTs (or prior alemtuzumab recipients must show prior clinical benefit), dosing is limited to initial 12 mg IV daily x5 (≤5 doses/12 months) or retreatment 12 mg IV daily x3 (≤3 doses/12 months), it must not be given with other MS DMTs, REMS enrollment is required, and authorizations/doses are limited to ≤12 months.

"Lemtrada (alemtuzumab) is proven and medically necessary for treatment of relapsing forms of multiple sclerosis (MS) (e."

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