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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

February 2018

Coverage of Exondys 51 with Prior Authorization


Effective immediately, Harvard Pilgrim is covering Exondys 51 (eteplirsen) for the treatment of Duchenne Muscular Dystrophy (DMD) with prior authorization for our commercial members.

DMD is a genetic disorder characterized by progressive muscle degeneration and weakness that usually appears during childhood and predominantly affects boys. It is caused by a mutation in the gene that codes for dystrophin, a protein that helps keep muscle cells intact. Exondys 51 is an injectable solution designed to facilitate dystrophin production.

Harvard Pilgrim covers Exondys 51 for commercial members when the policy criteria are met. For the criteria and other information, please refer to the Eteplirsen (Exondys 51) Injection Medical Policy.

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