Givosiran (Givlaari) (CPB 0961, reviewed 2026-01-09)
Aetna considers givosiran (Givlaari) medically necessary for acute hepatic porphyria (AHP) for commercial medical plans when the member is 18 years of age or older, is actively symptomatic or has had 4 or more porphyria attacks per year, and has an elevated urine porphobilinogen (PBG) or an elevated plasma or fecal porphyrin level. Continuation of therapy is considered medically necessary for members who are benefiting from it, such as through fewer porphyria attacks requiring hospitalization, urgent healthcare visits, or intravenous hemin. Aetna considers all other indications experimental, investigational, or unproven.