Cerdelga (eliglustat) — CareFirst (Caremark)

Initial criteria

• Member is age ≥ 18 years.
• Diagnosis of Gaucher disease is confirmed by enzyme assay demonstrating a deficiency of beta-glucocerebrosidase (glucosidase) enzyme activity or by genetic testing.
• Member is a CYP2D6 extensive metabolizer, intermediate metabolizer, or poor metabolizer as detected by an FDA‑cleared test.

Reauthorization criteria

• Member meets the criteria for initial approval.
• Member is not experiencing an inadequate response or any intolerable adverse events from therapy.

Approval duration

12 months