arimoclomol citrate
124 mg, 47 mg, 62 mg, 93 mg — Capsule
NEUROLOGICAL AGENTS MISCELLANEOUS
Also known as:
MIPLYFFA
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Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Blue Cross Blue Shield Federal
2 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Standard Option 2026
via Miplyffa |
Tier 5 - Non-Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via Miplyffa |
Tier 5 - Non-Preferred Specialty | ✓ | — | — | PA |