Acoramidis (Attruby) for transthyretin amyloid cardiomyopathy
Defines medical necessity and authorization criteria for Acoramidis (Attruby) for treatment of transthyretin-mediated cardiomyopathy in adults across Commercial, HIM, and Medicaid lines of business.
Criteria updated to align with FDA labeling for Attruby including diagnostic pathways, concomitant therapy exclusions, dosing, and age limits.
Coverage Criteria
Initial Therapy — Covered when ALL of the following are met
Covered when ALL of the following are met:
Initial ATTR-CM criteria
Diagnostic confirmation
- Tissue biopsy demonstrating amyloid protein identified as transthyretin by mass spectrometry or immunohistochemistry, with tissue of endomyocardial origin.
Non‑biopsy imaging pathway
- Echo, CMR, or PET findings consistent with cardiac amyloidosis.
- Cardiac radionuclide scan with Grade 2 or 3 uptake using one of: 99mTc‑DPD, 99mTc‑PYP, or 99mTc‑HMDP.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.