Actimmune (interferon gamma-1b) — Medica

Initial criteria

• Diagnosis has been established by ONE of the following: (a) patient has had radiographic (X-ray) imaging demonstrating skeletal features related to osteopetrosis; OR (b) patient has had a molecular genetic test identifying a gene-related pathogenic variant linked to severe, infantile malignant osteopetrosis (e.g., CA2, CLCN7, IKBLG, ITGB3, LRP5, OSTM1, PLEKHM1, SNX10, TCIRG1, TNFRSF11A, TNFSF11); AND
• Medication is prescribed by or in consultation with an endocrinologist.

Approval duration

1 year