Hympavzi (marstacimab-hncq) — United Healthcare
hemophilia A without inhibitors
Initial criteria
- Diagnosis of hemophilia A OR hemophilia B
- age ≥ 12 years
- Prescribed for the prevention of bleeding episodes (routine prophylaxis)
- No history of inhibitors to factor VIII (for hemophilia A) OR no history of inhibitors to factor IX (for hemophilia B)
Reauthorization criteria
- Documentation of positive clinical response to Hympavzi therapy
Approval duration
12 months