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Ruconest — Blue Cross Blue Shield of Illinois

Hereditary angioedema (HAE) acute treatment

Initial criteria

  • ONE of the following: (A) The requested agent is eligible for continuation of therapy AND prescriber states patient has been treated with the requested agent within the past 90 days (starting on samples not approvable) and is at risk if therapy is changed OR (B) other disease‑specific criteria (not shown in this excerpt)