Commercial Medical Policies for MedRx

Bone Modifiers

• Denosumab Products (Prolia) UM Medical De-Identified Download PDF
• Denosumab Products (Xgeva) UM Medical De-Identified Download PDF

Botulinum Toxins

• Botox UM Medical De-Identified Download PDF

Complement Inhibitors

• PiaSky UM Medical De-Identified Download PDF

Dermatology - Gene Therapy

• Vyjuvek UM Medical De-Identified Download PDF
• Zevaskyn UM Medical De-Identified Download PDF

Enzyme Replacement Therapy

• Fabrazyme UM Medical De-Identified Download PDF

Gaucher Disease - Enzyme Replacement Therapy

• Cerezyme UM Medical De-Identified Download PDF
• Elelyso UM Medical De-Identified Download PDF
• Vpriv UM Medical De-Identified Download PDF

Hematology - Gene Therapy

• Casgevy UM Medical De-Identified Download PDF
• Lyfgenia UM Medical De-Identified Download PDF
• Zynteglo UM Medical De-Identified Download PDF

Hemophilia - Non-Factor Routine Prophylaxis Products

• Hemlibra UM Medical De-Identified Download PDF

Immunologicals

• Cinqair UM Medical De-Identified Download PDF
• Fasenra UM Medical De-Identified Download PDF
• Nucala UM Medical De-Identified Download PDF
• Xolair UM Medical De-Identified Download PDF

Inflammatory Conditions

• Entyvio Intravenous UM Medical De-Identified Download PDF
• Ilumya UM Medical De-Identified Download PDF
• Skyrizi Intravenous UM Medical De-Identified Download PDF
• Tocilizumab Intravenous Products UM Medical De-Identified Download PDF
• Tremfya Intravenous UM Medical De-Identified Download PDF
• Ustekinumab Intravenous Products UM Medical De-Identified Download PDF

Metabolic Disorders - Primary Hyperoxaluria

• Rivfloza UM Medical De-Identified Download PDF

Neurology

• Gene Therapy

  • Lenmeldy UM Medical De-Identified Download PDF
• Imaavy UM Medical De-Identified Download PDF
• Rystiggo UM Medical De-Identified Download PDF
• Vyvgart Hytrulo UM Medical De-Identified Download PDF
• Vyvgart Intravenous UM Medical De-Identified Download PDF

Oncology (Injectable - Programmed Death Receptor-1)

• Keytruda UM Medical De-Identified Download PDF

Oncology (Intravesical)

• Adstiladrin UM Medical De-Identified Download PDF
• Anktiva UM Medical De-Identified Download PDF

Ophthalmology

• Vascular Endothelial Growth Factor Inhibitors

  • Susvimo UM Medical De-Identified Download PDF

• Gene Therapy

  • Encelto UM Medical De-Identified Download PDF

Repository Corticotropin

• Acthar Gel UM Medical De-Identified Download PDF

• Uplizna UM Medical De-Identified Download PDF