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Re: KashSmooth post# 12647

Friday, 04/30/2021 9:10:20 AM

Friday, April 30, 2021 9:10:20 AM

Post# of 17436
Re Cigna coverage for Lupkynis: What does section "ii" mean?

Cigna covers voclosporin (Lupkynis) as medically necessary when the following criteria are met for FDA Indications or Other Uses with Supportive Evidence:

1. Lupus Nephritis. Approve for the duration noted if the individual meets ONE of the following (A or B):
A) Initial Therapy. Approve for 6 months if the individual meets ALL of the following conditions (i, ii, iii, iv,and v):
i. Individual is ≥ 18 years of age; AND

ii. Individual has autoantibody-positive systemic lupus erythematosus (SLE), defined as positive for antinuclear antibodies (ANA) and/or anti-double-stranded DNA (anti-dsDNA) antibody;......


TIA for any clarity on the above

https://static.cigna.com/assets/chcp/pdf/coveragePolicies/NPF/npf_656_coveragepositioncriteria_lupkynis_pa.pdf


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