Kaiser Foundation Health Plan Northern California
Elaprase (idursulfase)
Drugs for Metabolic Disease : Drugs for Metabolic Disease
  • PA Applies
  • Cutaneous T-Cell Lymphomas:
    Duration: 1 year(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A

    Systemic Anaplastic Large Cell Lymphoma:
    Duration: 1 year(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialty Pharmacy Provider(s): Accredo Health Group, Inc.
    Reauthorization Required: No
    Duration of Reauthorization: N/A

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