VIMIZIM (elosulfase alfa)

VIMIZIM (elosulfase alfa)

OFFICE ADMINISTRATION

Indications for Prior Authorization:

• Treatment of patient with mucopolysaccharidosis type IVA (Morquio A syndrome)

Patients must meet the following criteria for the indications above:

• Patients must have Morquio A syndrome, a genetic lysosomal storage disorder

This Medication is Not Approvable for the following condition(s):

• Any condition not listed above.

Dosing:

• Administer 2 mg/kg intravenously once weekly
• Administer over 3.5 to 4.5 hours

Approval Period:

One year