Medical benefit pharmaceutical policies for providers
See the latest updates to our medical benefit pharmaceutical policies.
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.
MBP 173.0 Fasenra (benralizumab)
Fasenra (benralizumab), a humanized monoclonal antibody (IgG1, kappa), is an interleukin-5 antagonist. IL-5 is the major cytokine responsible for the growth and differentiation, recruitment, activation, and survival of eosinophils (a cell type associated with inflammation and an important component in the pathogenesis of asthma). Benralizumab, by inhibiting IL-5 signaling, reduces the production and survival of eosinophils.
New Policy 5/15/18
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.
Learn more about Geisinger Health Plan.
Log in to NaviNet to access and view prior authorization information.
Clinical guidelines offer providers consistent and appropriate guidance for diagnosis and treatment of specific conditions or diseases.
Terms and conditions
View GHP’s terms and conditions.
Questions? Contact us
If you have questions or need more information, contact Geisinger Health Plan.