Anthem Blue Cross California Adakveo (crizanlizumab Form

Effective Date

06/20/2023

Last Reviewed

05/19/2023

Original Document

  Reference



Overview

This document addresses the use of Adakveo (crizanlizumab). Crizanlizumab is a monoclonal antibody that binds to and inhibits P-selectin, an adhesion protein found on the surface platelets and endothelial cells. In those with sickle cell disease, P-selectin promotes blood vessels \

HCPCS

J0791

Injection, crizanlizumab-tmca, 5 mg (Adakveo) (Effective 7/1/2020)

ICD-10 Diagnosis

D57.00-D57.819

Sickle Cell Disease

Document History

Revised: 05/19/2023