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Alhemo (concizumab-mtci)Medica

Hemophilia A without Factor VIII inhibitors

Initial criteria

  • age ≥ 12 years
  • using Alhemo for routine prophylaxis to prevent or reduce the frequency of bleeding episodes
  • moderately severe to severe hemophilia A with baseline Factor VIII level ≤ 2%
  • EITHER (Factor VIII inhibitor titer testing performed within 30 days AND no positive test ≥ 1.0 Bethesda units/mL) OR (no prior Factor VIII therapy)
  • prophylactic use of Factor VIII products will be discontinued before the initial Alhemo dose (use for breakthrough bleeding permitted)
  • prescribed by or in consultation with a hemophilia specialist

Reauthorization criteria

  • using Alhemo for routine prophylaxis to prevent or reduce the frequency of bleeding episodes
  • prophylactic use of Factor VIII products will not occur while receiving Alhemo (use for breakthrough bleeding permitted)
  • experienced a beneficial response to therapy (e.g., reduction in bleeding events, severity, or spontaneous bleeds)
  • prescribed by or in consultation with a hemophilia specialist

Approval duration

1 year