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Myalept (metreleptin)United Healthcare

congenital generalized lipodystrophy

Initial criteria

  • Diagnosis of congenital or acquired generalized lipodystrophy associated with leptin deficiency
  • AND Myalept is being used as an adjunct to diet modification

Reauthorization criteria

  • Documentation of positive clinical response to Myalept therapy
  • AND Myalept is being used as an adjunct to diet modification

Approval duration

12 months