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(belimumab) Injectable Medication Precertification Request. (belimumab) Injectable Medication Precertification Request

(belimumab) Injectable Medication Precertification Request. (belimumab) Injectable Medication Precertification Request 2025

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The document is a precertification request form for the injectable medication Benlysta® (belimumab), used primarily for treating systemic lupus erythematosus (SLE). It requires detailed patient, insurance, prescriber, and clinical information to assess eligibility for treatment. The form includes sections for patient demographics, insurance coverage, prescriber details, administration information, product specifics, diagnosis codes, and clinical criteria necessary for initiating or continuing therapy.

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How much does belimumab cost?

Benlysta (belimumab) is a member of the selective immunosuppressants drug class and is commonly used for Lupus, Lupus Erythematosus, and Lupus Nephritis. The cost for Benlysta 120 mg intravenous powder for injection is around $672 for a supply of 1 powder for injection, depending on the pharmacy you visit.

What is the drug belimumab approved for?

FDA approves Benlysta (belimumab) Autoinjector for children with systemic lupus erythematosus.

What is the indication of belimumab injection?

In the US, belimumab is indicated to treat active systemic lupus erythematosus (SLE) and active lupus nephritis in patients aged five years and older who are receiving standard therapy.

What is the target of belimumab?

BENLYSTA (belimumab) is designed for lupus. BENLYSTA is the only biologic with a mechanism of action that selectively targets the B-lymphocyte stimulator protein, or BLyS, a known underlying cause of systemic lupus erythematosus, or SLE, with or without lupus nephritis.

What is belimumab approved for?

FDA approves Benlysta (belimumab) Autoinjector for children with systemic lupus erythematosus. At-home treatment is the first and only in its class for pediatric patients aged five years and older with systemic lupus erythematosus.

Is belimumab the same as Benlysta?

Belimumab (Benlysta) Belimumab is an immunosuppressant drug approved by the FDA for the treatment of lupus and lupus nephritis in children and adults.

What is the drug belimumab used for?

Belimumab is used with other medications to treat certain types of systemic lupus erythematosus (SLE or lupus; an autoimmune disease in which the immune system attacks healthy parts of the body such as joints, skin, blood vessels, and organs) in adults and children 5 years of age and older.

(belimumab) Injectable Medication Precertification Request. (belimumab) Injectable Medication Precertification Request 2025

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