CurrentMolina HealthcarePolicy C21970-A

Saphnelo (anifrolumab-fnia) Drug and Biologic Coverage Criteria

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Governs prior authorization and coverage of intravenous Saphnelo for adults with moderate to severe systemic lupus erythematosus receiving standard therapy, including clinical criteria, documentation, prescriber qualifications, dosing, and administration-site requirements.

Policy Summary

PayerMolina Healthcare

PolicySaphnelo (anifrolumab-fnia) Drug and Biologic Coverage Criteria

Policy CodePolicy C21970-A

Change TypeNo material clinical or coverage changes

Effective DateDecember 28, 2025

Next Review DateOctober 1, 2026

Key ActionEnsure Saphnelo is prescribed by or in consultation with a board-certified rheumatologist or a physician who specializes in treating systemic autoimmune diseases.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

18+Minimum member age

300 mgDose

Every 4 weeksFrequency

6 monthsInitial authorization

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