Specialty pharmacy benefit — both Ionis products are self-injected, specialty-only
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48 patients today
2 updatesJun 1, 2026 May 18, 2026
CareSource · PBM: Express Scripts · Michigan
CareSource (Marketplace, MI)
Marketplace plan requiring specialist involvement and genetic confirmation for Tryngolza.
Marketplace
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 | Must be prescribed by or in consultation with an endocrinologist, cardiologist, or lipid specialist. Diagnosis of FCS confirmed by genetic test. | 6 months initial | 2025-07-01 | Tryngolza Pharmacy Policy | Sourced |
Coverage Update YTD
2Across all sources
Treated Lives — Tryngolza (FCS)
48Patients 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 · 4M4 · 12M8 · 22M12 · 32M18 · 41M24 · 48
50-state distribution · illustrative
Treated Lives by State — Tryngolza (FCS)
Fewer patientsMore patients
NE high
AI SUMMARY
Tryngolza — FCS Coverage Source Summary
Marketplace pharmacy policy published for Tryngolza FCS with specialist prescribing and dietary documentation requirements.
Historical coverage trend
Tryngolza — FCS Lives Coverage Trend
% of lives by access status across historical snapshots.
CoveredPreferredNot coveredUnknown
Covered
67%+59 pts
Preferred
56%+51 pts
Not covered
8%-12 pts
Unknown
24%+18 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