Description: Inj efgartigimod 2mg
Unit: 2 mg
Pay quarter: Q4 2023
Dosage and Frequency
• 10mg/kg (max 1200mg) IV every 1 week for 4 weeks
Calculate drug reimbursement
(ASP: $12,116.23, Margin: $726.97)
# Units to bill:400
Prior auth criteria for Vyvgart may include but is not limited to:
1. Diagnosis of gMG as evidenced by positive results on one of the following diagnostic tests:
- Repetitive nerve stimulation
- Single-fiber electromyography
- Visual evoked potentials
2. Patient is at least 18 years old.
3. Patient is not pregnant or planning to become pregnant.
4. Patient has not received a prior course of Vyvgart.
5. Patient is not enrolled in a clinical trial for gMG.
6. Patient has not received any other treatments for gMG, such as immunosuppressive agents, anti-inflammatory drugs, or immunoglobulin, within the past 6 months.
7. Patient does not have any active malignancy.
8. Patient is not receiving any other investigational drug or device treatment.
Insurance prior auth guidelines:
EFGARTIGIMOD ALFA-FCAB (ARGENX)