Specialty pharmacy benefit — both Ionis products are self-injected, specialty-only
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150 patients today
2 updatesJun 1, 2026 May 18, 2026
CVS Health · PBM: CVS Caremark · Multi-state
Aetna Better Health (Medicaid, multi-state)
Medicaid plan with published Tryngolza coverage guideline requiring genetic or score-based FCS confirmation.
Managed Medicaid
Live from the coverage database
Policy Posture and UM Criteria by Indication
| INDICATION | STATUS | PUBLISHED CRITERIA | AUTH DURATION | EFFECTIVE | SOURCE | CONFIDENCE |
|---|---|---|---|---|---|---|
| Tryngolza (FCS) | Published — Restricted | Confirmed FCS diagnosis by genetic testing (biallelic pathogenic variants in LPL, GPIHBP1, APOA5, APOC2, LMF1, GPD1, or CREB3L3), or if genetic testing is inconclusive, a clinical diagnosis using Moulin or NAFCS scoring criteria. | 6-12 months depending on state | 2026-06-01 | Tryngolza (olezarsen) Coverage Policy/Guideline | Sourced |
Coverage Update YTD
3Across all sources
Treated Lives — Tryngolza (FCS)
150Patients on therapy
Ionis Brands Published
1 / 3Have a policy
Pending Policy Changes
1Next 30 days
Months since launch · illustrative
Treated Lives on Therapy — Tryngolza (FCS)
M1 · 12M4 · 36M8 · 68M12 · 99M18 · 128M24 · 150
50-state distribution · illustrative
Treated Lives by State — Tryngolza (FCS)
Fewer patientsMore patients
AR high
AI SUMMARY
Tryngolza — FCS Coverage Source Summary
Published FCS pharmacy policy with genetic/biochemical confirmation and specialist attestation applied across the managed Medicaid footprint.
Historical coverage trend
Tryngolza — FCS Lives Coverage Trend
% of lives by access status across historical snapshots.
CoveredPreferredNot coveredUnknown
Covered
69%+53 pts
Preferred
56%+51 pts
Not covered
8%-12 pts
Unknown
25%+17 pts
Latest source details
Tryngolza — FCS Coverage Details
3 source views
| Source | Payment Type | Policy Status | Latest Detail |
|---|---|---|---|
| MMIT Searchlight | Commercial | Published — Restricted | Syndicated data reflects the most recent policy language for this indication. |
| FRM submission | Medicare | Limited visibility | Field team confirms account-level nuance not yet captured in syndicated sources. |
| Market Access submission | Medicaid | Limited visibility | State/plan-level detail requires validation against current directories. |
Brand-specific feed
Latest Updates
MMIT Searchlight
Latest source refresh confirms no material change to published criteria this cycle.
FRM submission
Field notes on account-level access nuance submitted for validation.
Brand documents
Shared Documents
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Policy PDF
Uploaded by Market Access Team
Latest updated: Jun 1, 2026