Serostim — Highmark
Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS)-Wasting
Initial criteria
- Diagnosis of HIV or AIDS
- Currently taking antiretroviral therapy
- Weight loss of at least 10% from baseline
Reauthorization criteria
- Member has experienced and maintained an increase in weight from the start of therapy
Approval duration
initial 12 weeks; reauthorization 12 months