Patients eligible for coverage include those with a confirmed diagnosis of DMD and the ability to walk without wheelchair assistance. The treatment must also be medically necessary and not used experimentally, according to Humana’s policy.
Cambridge, Mass.-based Sarepta gained U.S. Food and Drug Administration approval for the drug eteplirsen in September after a months-long review process that sparked a heated internal debate.
Per patient per year, the drug costs about $300,000. Minnetonka, Minn.-based insurer UnitedHealthcare said it will cover the drug, but Indianapolis-based Anthem said it will not cover eteplirsen.
More articles about payer issues:
Federal exchange premium increases surpass Covered California hikes
Republicans call for updated tally of government subsidy expenditure
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