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Medications listed are available on OH EPIC Formulary, unless otherwise noted.
Not all formulary medications are available at each facility. Please refer to your local pharmacy for available inventory.
Not all formulary medications are available at each facility. Please refer to your local pharmacy for available inventory.
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efgartigimod alfa
efgartigimod alfa
- Ambulatory: Outpatient Infusion, Home Infusion
Additional Information and Links
- Indication: treatment of generalized myasthenia gravis (gMG) in adult patients who are anti-acetylcholine receptor (AChR) antibody positive
- Service Line: Neurology
- Formulary Location: Outpatient
- Service location: Outpatient Infusion, Home Infusion
- Patient Population: Adult
- Prior Authorization Required: Yes
- Restriction/Criteria of Use (all will apply, unless specified):
- Diagnosis of generalized MG with a positive serological test for anti-AChR antibodies
- Patient has a Myasthenia Gravis Foundation of America (MGFA) Clinical Classification of class II, III, or IV disease at the start of therapy
- Patient has Myasthenia Gravis-Activities of Daily Living (MG-ADL) score ≥ 5
- Must not be used with other biologic therapies for myasthenia gravis or immunoglobulin therapy
- Trial and failure, contraindications or intolerance to at least one (1) immunosuppressive therapy (e.g., corticosteroids, methotrexate, azathioprine, cyclophosphamide, cyclosporine, mycophenolate mofetil, or tacrolimus)
- Six month trial and failure of eculizumab or ravulizumab
Last updated: Aug. 29, 2023