pakman schreef op 22 december 2021 11:45:
Aetna
Hereditary Angioedema
09.29.2021,
Brand Selection for Medically Necessary Indications
As defined in Aetna commercial policies, health care services are not medically necessary when they are more costly than alternative services that are at least as likely to produce equivalent therapeutic or diagnostic results. Berinert (human C1 esterase inhibitor) is more costly to Aetna than other hereditary angioedema agents for acute attacks of hereditary angioedema. There is a lack of reliable evidence that Berinert is superior to the lower cost hereditary angioedema agent, Ruconest (recombinant C1 esterase inhibitor), for acute attacks of hereditary angioedema. Therefore, Aetna considers Berinert to be medically necessary only for members who have a contraindication, intolerance or ineffective response to the available equivalent alternative hereditary angioedema agent (one-month trial): Ruconest.