CMS Lymphocyte Immune Globulin, Anti-Thymocyte Globulin (Equine) Form


Lymphocyte Immune Globulin, Anti-Thymocyte Globulin (Equine)

Notes: Lymphocyte Immune Globulin, Anti-Thymocyte Globulin (Equine) is considered an adjunctive therapy to conventional immunosuppressive drugs, not a replacement.

Indications

(261283) Is the patient undergoing treatment for renal allograft rejection? 

Contraindications

(261284) Is the lymphocyte immune globulin preparation not approved by the FDA for the indication of renal allograft rejection? 
Effective Date

01/01/2066

Last Reviewed

NA

Original Document

  Reference



Background for this Policy

The lymphocyte immune globulin preparations are biologic drugs not previously approved or licensed for use in the management of renal allograft rejection. A number of other lymphocyte immune globulin products of equine, lapine, and murine origin are currently under investigation for their potential usefulness in controlling allograft rejections in human transplantation. These biologic drugs are viewed as adjunctive to traditional immunosuppressive products such as steroids and anti- metabolic drugs. At present, lymphocyte immune globulin preparations are not recommended to replace conventional immunosuppressive drugs, but to supplement them and to be used as alternatives to elevated or accelerated dosing with conventional immunosuppressive agents.

The FDA has approved one lymphocyte immune globulin preparation for marketing, lymphocyte immune globulin, anti-thymocyte globulin (equine). This drug is indicated for the management of allograft rejection episodes in renal transplantation. It is covered under Medicare when used for this purpose. Other forms of lymphocyte globulin preparation which the FDA approves for this indication in the future may be covered under Medicare.