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Eculizumab / Immunosuppressants / Complement deficiency / Alexion Pharmaceuticals / Paroxysmal nocturnal hemoglobinuria / Hemoglobinuria / Hemolytic-uremic syndrome / Medical prescription / Haemophilus influenzae / Health / Medicine / Acquired hemolytic anemia


MEDICAL ASSISTANCE HANDBOOK PRIOR AUTHORIZATION OF PHARMACEUTICAL SERVICES 1. Requirements for Prior Authorization of Soliris (eculizumab) A.
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Document Date: 2014-12-29 17:37:38

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File Size: 129,28 KB

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Company

Alexion Pharmaceuticals Inc. / /

Facility

Terminal Complement Inhibitor Eculizumab / /

IndustryTerm

treatment of a diagnosis of atypical hemolytic uremic syndrome / /

MedicalCondition

Haemophilus influenza / Complement-mediated hemolytic uremic syndrome / Atypical Hemolytic-Uremic Syndrome / paroxysmal nocturnal hemoglobinuria / atypical hemolytic uremic syndrome / /

MedicalTreatment

vaccination / /

Position

physician / /

Product

Soliris / A. Prescriptions That Require Prior Authorization All prescriptions / RENEWALS OF PRESCRIPTIONS / /

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