Description: C-1 esterase, berinert
Unit: 10 units
Pay quarter: Q4 2023
Dosage and Frequency
• 20IU/kg IV PRN
Calculate drug reimbursement
(ASP: $9,721.66, Margin: $583.30)
# Units to bill:160
Prior auth criteria for Berinert may include but is not limited to:
• The patient must have a confirmed diagnosis of HAE.
• The patient’s symptoms must be severe enough to require treatment with C1-INH for rapid relief of symptoms.
• The patient must not have had any previous treatment with C1-INH (human) within the past seven days.
• The patient must not have any known hypersensitivity or anaphylactic reaction to C1-INH or any of Berinert’s components.
• The patient must not have any known malignancies or malignancy-related complications.
• The patient must not be pregnant or breastfeeding.
• The patient must not be taking any medications that interact with Berinert.
• The patient must not have any other serious medical conditions that would interfere with the efficacy of Berinert.
Insurance prior auth guidelines:
BERINERT (CSL BEHRING LLC)