Fasenra Coverage Policy
Defines drug quantity limits, exceptions, and medical-necessity override criteria for Fasenra (benralizumab subcutaneous injection) for retail and home delivery, including induction dosing and EGPA-specific allowances. Approval durations and one-time override rules are specified.
New quantity limit of 0.5 mL (1 syringe) per 56 days at retail and home delivery for Fasenra 10 mg/0.5 mL prefilled syringes was added.
One-time overrides for patients initiating therapy at induction dosing for asthma were updated to approve for 84 days.
Override for EGPA: 1 mL per 28 days at retail and 3 mL per 84 days at home delivery for 30 mg/mL pens and prefilled syringes was added.
Policy Statement clarified that approvals are provided for 1 year in duration unless otherwise noted and that 'one-time' overrides are provided for the duration noted in criteria.
Annual Revision summary noted 'No criteria changes' for 08/04/2023.
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