Specialty pharmacy benefit — both Ionis products are self-injected, specialty-only
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1,020 patients today
2 updatesJun 1, 2026 May 18, 2026
UnitedHealth Group · PBM: Optum Rx · National
UnitedHealthcare
Dawnzera added non-preferred with step through Takhzyro. FCS genetic confirmation required for Tryngolza.
CommercialMedicare Part DManaged Medicaid
Live from the coverage database
Policy Posture and UM Criteria by Indication
| INDICATION | STATUS | PUBLISHED CRITERIA | AUTH DURATION | EFFECTIVE | SOURCE | CONFIDENCE |
|---|---|---|---|---|---|---|
| Dawnzera (HAE) | Published — Restricted | Listed on UnitedHealthcare's Prior Authorization / Medical Necessity required drug list for commercial plans. Specific clinical criteria not captured in this summary — pull the full policy document for detail. | Not specified in summary | Not specified in summary | Clinical Pharmacy PA/Notification/Medical Necessity List | Sourced |
Coverage Update YTD
11Across all sources
Treated Lives — Tryngolza (FCS)
1,020Patients on therapy
Ionis Brands Published
1 / 3Have a policy
Pending Policy Changes
3Next 30 days
Months since launch · illustrative
Treated Lives on Therapy — Tryngolza (FCS)
M1 · 82M4 · 245M8 · 459M12 · 673M18 · 867M24 · 1,020
50-state distribution · illustrative
Treated Lives by State — Tryngolza (FCS)
Fewer patientsMore patients
SC high
AI SUMMARY
Tryngolza — FCS Coverage Source Summary
FCS genetic confirmation requirement is consistently applied across books; renewal documentation still mirrors the initial-authorization bar.
Historical coverage trend
Tryngolza — FCS Lives Coverage Trend
% of lives by access status across historical snapshots.
CoveredPreferredNot coveredUnknown
Covered
92%+81 pts
Preferred
78%+70 pts
Not covered
8%-12 pts
Unknown
32%+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
Shared Documents
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Policy PDF
Uploaded by Market Access Team
Latest updated: Jun 1, 2026