Alot depends on insurance company and drs office. When my Dr started giving rituxan for patients who have failed everything, the nurse sent pages of info and used the wording that got fastest go ahead for everyone after. I got approved for rituxan in 2 months. It's sad that something works but not on approved illness list.I think most get ivig monthly and it's alot of mgers!!! Who knows what insurance thinks other than to save $$$

I was on IVIG for 4 years. Started out taking it monthly and by the end of the 4 years I was getting it weekly. After asking the doctor about it, she said she spoke to a representative of the insurance company who informed her that the request for IVIG is automatically denied by computer when it comes in. The doctor then has to call and explain why I need it, and then it was always approved. Many doctors won't take the extra time and effort to make the call and so it stays denied. Mine was always denied when first sent in and a couple of times between the denial and the later approval I ended up in the hospital with a crisis. I only stopped taking IVIG a few months ago because it's effectiveness was was reduced to only about 3 or 4 days, so we switched to plasmapharesis. It worked great for me for several years though, and I got to where I had very little side effects. Hope you do well.

I've been getting IVIG every month for a year and a half. My neuro recently changed it to every 2 and 3 weeks rotating. Ivig has given me my life back. I still have limitations, but I have more choices on what to spend my energy on.

The success of obtaining prior authorization lies largely with your physician. The wording in the statement of medical necessity they provide is key to approval. An initial denial is not the end. There is an appeal process that should be used if all else fails.

The FDA approves the indications, or uses, for a drug based on what evidence is submitted by the manufacturer during clinical testing. Once the drug reaches the market, drugs may be prescribed by the physician for other indications. For expensive drugs, like IVIG, insurance companies try to contain unnecessary expenses using the prior authorization process. Legally, they only have to cover a drug for its approved indications. However, when there is valid evidence for using a drug for a non-approved indication, such as IVIG for MG, your doctor can advocate for you by submitting the reasons the request should be approved. It should include information about your condition, treatments that have been tried and failed, and clinical supporting evidence for using the drug for your condition. IVIG is considered by the medical community to be effective for MG in the literature despite not being part of the FDA approved indications. This is known as a medically accepted indication.

Using the proper terminology by your physician and providing the key information will lead to successful coverage of IVIG with your insurance company. Good luck.

thank you all for your replies. I am going to see my doctor next week hopefully all will be fine
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L