Description: Inj., benralizumab, 1 mg
Unit: 1 mg
Pay quarter: Q4 2023
Dosage and Frequency
• 30mg SQ every 4 weeks for first 3 doses
• 30mg SQ every 8 weeks
Calculate drug reimbursement
(ASP: $4,827.14, Margin: $289.63)
# Units to bill:30
Prior auth criteria for Fasenra may include but is not limited to:
• The patient must be over the age of 18 years old.
• The patient must have been diagnosed with severe eosinophilic asthma.
• The patient must be using a high-dose inhaled corticosteroid with a long-acting beta2-agonist.
• The patient must have had inadequate control of asthma symptoms despite using other asthma medications as prescribed.
• The patient must not be pregnant or breastfeeding.
• The patient must not have any known or suspected allergy to benralizumab.
• The patient must not have an immunocompromised or immunodeficient condition.
• The patient must not be currently receiving other biologic therapies, such as omalizumab.
Insurance prior auth guidelines: