Fensolvi
Coverage and utilization management policy for Fensolvi 45 mg subcutaneous kit for treatment of central precocious puberty and gender dysphoria across Medicaid, Commercial, and MMP lines; includes initial and renewal criteria, dosing, quantity limits, billing codes, and supporting evidence.
No material clinical/coverage changes identified.
Coverage Summary
Scope: Coverage and utilization management policy for Fensolvi 45 mg subcutaneous kit for treatment of central precocious puberty (CPP) and gender dysphoria across Medicaid, Commercial, and MMP lines of business. Dose strength is 45 mg administered once every 6 months with a days supply of 168 days (Quantity = 1 injection per 168 days). Authorization is provided for 12 months and may be renewed. For MMP members who have previously received this medication within the past 365 days, step therapy requirements do not apply. Effective date: 2025-03-01; Last review: 01/2025.
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