sibeprenlimab-szsi

400 mg/2 mL (200 mg/mL) — Prefilled Syringe

NEPHROLOGY AGENTS MISCELLANEOUS

Also known as: VOYXACT

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Aug 7, 2026  ·  Checked: 8 hours, 53 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026
via Voyxact
Tier 5 - Non-Preferred Specialty PA
Source: Excel (XLSX)  ·  Formulary date: Jul 31, 2026  ·  Checked: 8 hours, 53 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary PA
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