ELREXFIO (elranatamab-bcmm)

ELREXFIO (elranatamab-bcmm)

Medical Administration – injectable

Diagnosis considered for coverage:

• Indicated for the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least four prior lines of therapy including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody

Coverage Criteria:

For diagnosis of relapsed or refractory multiple myeloma:

• Patient has a diagnosis of multiple myeloma; AND
• Disease is one of the following:
  • Relapsed 
  • Refractory; AND
• Patient has received at least four prior lines of therapy which include all of the following:
  • An immunomodulatory agent (e.g., lenalidomide, thalidomide) 
  • A proteasome inhibitor (e.g., bortezomib, carfilzomib) 
  • A CD38-directed monoclonal antibody (e.g., daratumumab)

Reauthorization Criteria:

For diagnosis of relapsed or refractory multiple myeloma:

• Patient does not show evidence of progressive disease while on therapy

Dosing: 

• Step-up Dose
  • 12 mg on Day 1
  • 32 mg on Day 4
• Treatment Dose
  • 76 mg on Day 8
  • 76 mg weekly thereafter through Week 24
  • 76 mg every 2 weeks on Week 25 and every 2 weeks thereafter (responders only Week 25 onward)

Coverage Duration: 

• Initial: 1 year
• Reauthorization: 1 year

Authorization is not covered for the following:

The use of this drug for indications not listed in this policy does not meet the coverage criteria established by the Western Health Advantage (WHA) Pharmacy and Therapeutics (P&T) Committee.

Additional Information:

• Elrexfio is intended for subcutaneous use by a healthcare provider only
• Elrexfio 76 mg/1.9 mL (40 mg/mL) vial and 44 mg/1.1 mL (40 mg/mL) vial are supplied as ready-to-use solution that do not need dilution prior to administration

Policy Updates:

• 3/1/2024 – New policy approved by WHA P&T Committee. (P&T, 2/20/2024)

References:

• Elrexfio Prescribing Information. Pfizer, Inc. New York, NY. August 2023.