CommercialCoverageMedium impact
08.02.13a, Delandistrogene moxeparvovec (delandistrogene moxeparvovec-rokl; Elevidys®)
Independence Blue Cross·Neurology, Pediatrics, Family Medicine·Pharmacy
Effective date
May 28, 2025
We identified it
Jun 19, 2026
Summary
This is a reissue of the policy for Delandistrogene moxeparvovec (Elevidys®), a gene therapy for Duchenne muscular dystrophy. The policy has been updated for commercial plans with a future reissue effective date of May 28, 2025.
Action Required
Before May 28, 2025: Billing team should review the updated policy for Elevidys® (delandistrogene moxeparvovec) at the provided URL to understand any changes to coverage criteria, prior authorization requirements, or billing guidelines for this gene therapy. Update internal protocols and staff training accordingly as this is a high-cost specialty medication.