Specialty pharmacy benefit — both Ionis products are self-injected, specialty-only
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540 patients today
2 updatesJun 1, 2026 May 18, 2026
Centene Corporation · PBM: Express Scripts · National
Centene
Medicaid-heavy. State-by-state variability on FCS diagnosis documentation requirements.
Managed MedicaidMedicare Part D
Live from the coverage database
Policy Posture and UM Criteria by Indication
| INDICATION | STATUS | PUBLISHED CRITERIA | AUTH DURATION | EFFECTIVE | SOURCE | CONFIDENCE |
|---|---|---|---|---|---|---|
| Tryngolza (sHTG) | Published — Restricted | Fasting triglycerides >= 500 mg/dL required for the hypertriglyceridemia authorization bucket, separate from the FCS-specific genetic criteria (Coordinated Care, Medicaid MI - PEPP). | Not specified in summary | 2026-01-01 | CP.PHAR.689 Olezarsen (Tryngolza) | Sourced |
Coverage Update YTD
5Across all sources
Treated Lives — Tryngolza (FCS)
540Patients on therapy
Ionis Brands Published
1 / 3Have a policy
Pending Policy Changes
2Next 30 days
Months since launch · illustrative
Treated Lives on Therapy — Tryngolza (FCS)
M1 · 43M4 · 130M8 · 243M12 · 356M18 · 459M24 · 540
50-state distribution · illustrative
Treated Lives by State — Tryngolza (FCS)
Fewer patientsMore patients
TN high
AI SUMMARY
Tryngolza — FCS Coverage Source Summary
Medicaid-heavy book with state-by-state variability on FCS diagnosis documentation requirements.
Historical coverage trend
Tryngolza — FCS Lives Coverage Trend
% of lives by access status across historical snapshots.
CoveredPreferredNot coveredUnknown
Covered
79%+72 pts
Preferred
68%+60 pts
Not covered
8%-12 pts
Unknown
28%+23 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
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Policy PDF
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Latest updated: Jun 1, 2026