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UnitedHealthcare Releases Coverage Detail of Sarepta Therapeutics (SRPT) Exondys 51

December 1, 2016 9:58 AM EST

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UnitedHealthcare released its official coverage for Sarepta Therapeutics (NASDAQ: SRPT) Exondys 51 (eteplirsen)

Exondys 51 (eteplirsen) may be covered for:1

  • The treatment of Duchenne muscular dystrophy (DMD) in patients who meet all of the following criteria:
    • a. For initial therapy, all of the following:
      • (1) Diagnosis of Duchenne muscular dystrophy AND
      • (2) Submission of medical records (e.g., chart notes, laboratory values) confirming the mutation of the DMD gene is amenable to exon 51 skipping.1,2 AND
      • (3) Exondys 51 dosing for DMD is in accordance with the United States Food and Drug Administration approved labeling: maximum dosing of 30 mg/kg infused once weekly. AND
      • (4) Initial authorization will be for no more than 4 weeks.
    • b. For continuation therapy, all of the following:
      • (1) Exondys 51 dosing for DMD is in accordance with the United States Food and Drug Administration approved labeling: maximum dosing of 30 mg/kg infused once weekly. AND
        • (2) Reauthorization will be for no more than 6 months Exondys 51 will not be covered for other forms of muscular dystrophy1

Exondys 51 will not be covered for other forms of muscular dystrophy.



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