UnitedHealthcare
Empaveli (pegcetacoplan)
Drugs for the Blood : Drugs for the Blood
  • Paroxysmal Nocturnal Hemoglobinuria:
    Duration: 6 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

  • Prior Authorization: Paroxysmal Nocturnal Hemoglobinuria:
    Documented Diagnosis: Yes
    Duration: 6 Month(s)
    Reauthorization Required: Yes