Health Net
Fabrazyme (agalsidase beta)
Drugs for Metabolic Disease : Drugs for Metabolic Disease
  • Prior Authorization: Fabry's Disease:
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Age Requirement: >= 2
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Fabry's Disease:
    Age Requirement: >= 2
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Specialist Type(s): 1 of Appropriate Specialist;Cardiologist;Geneticist;Nephrologist;Neurologist
    Reauthorization Required: Yes
    Duration of Reauthorization: >= 6 month(s)

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