Mavenclad (cladribine) — Highmark

Initial criteria

• age ≥ 18 years
• Diagnosis of multiple sclerosis (ICD-10: G35) classified as relapsing-remitting or active secondary progressive disease
• Therapeutic failure or intolerance to at least one other disease-modifying therapy (e.g., Avonex, Betaseron, Gilenya, Copaxone, Tysabri, Ocrevus)

Reauthorization criteria

• Additional approvals should not be granted as Mavenclad is not considered safe beyond two years

Approval duration

up to 2 years