Medical benefit pharmaceutical policies for providers

See the latest updates to our medical benefit pharmaceutical policies. 

Choose a letter to view policies by first letter:

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

F

MBP 18.0 Fabrazyme (agalsidase beta)
Fabrazyme (agalsidase beta) is approved by the FDA for use in members with Fabry disease. Fabry disease is a progressive X-linked genetic disorder which causes a deficiency in the enzyme alpha-galactosidase A. This deficiency allows glycosphingolipids to accumulate in the vascular endothelium and visceral tissues throughout the body.
Reviewed 1/30/17

MBP 61.0 Flolan or Veletri (epoprostenol)
Flolan or Veletri (epoprostenol) is a man-made form of a naturally occurring molecule in the human body called prostaglandin which helps the body open blood vessels.
Revised 5/19/17

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