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Anti-CD20 monoclonal antibody (subcutaneous)

Kesimpta (ofatumumab) Letter of Medical Necessity

Kesimpta (ofatumumab) is a self-administered subcutaneous anti-CD20 for MS. PAs may require step therapy through preferred DMTs.

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FDA-Approved Indications

  • ● relapsing forms of multiple sclerosis

Why Kesimpta Prior Authorization Gets Denied

The most common denial reasons across major payers:

  1. 1. Step therapy through other DMTs
  2. 2. Hepatitis B screening missing
  3. 3. Disease activity documentation insufficient

What to Include in a Kesimpta Letter of Medical Necessity

Document MS diagnosis, disease activity, MRI findings, prior DMTs, hepatitis B screening, immunoglobulin levels, and rationale for self-administered anti-CD20.

Key clinical evidence to cite:

  • ✓ ASCLEPIOS I and II trials

Relevant guidelines:

  • 📖 AAN MS Guidelines

Kesimpta Prior Authorization Criteria

Standard criteria across major US payers for Kesimpta. Specific criteria vary by plan — RxCheckUp tailors each LMN to your patient's exact payer policy.

Typical step therapy requirements:

  • → Step therapy through other DMTs

Required documentation:

  • ✓ ICD-10 diagnosis code with specificity
  • ✓ Prior therapy history with dates, doses, and discontinuation reasons
  • ✓ Specialist evaluation (where applicable)
  • ✓ Baseline disease activity or biomarker results
  • ✓ Clinical rationale citing FDA labeling or guidelines

Approval details:

Initial approval: typically 6 months. Renewal: 12 months with documented clinical response.

Payers Covering Kesimpta

RxCheckUp tailors each LMN to the specific payer's medical policy and step therapy requirements:

UnitedHealthcareAetnaCignaBCBSMedicare Part D

Kesimpta Prior Authorization FAQ

Why was my Kesimpta prior authorization denied?

The most common denial reasons for Kesimpta are: Step therapy through other DMTs; Hepatitis B screening missing; Disease activity documentation insufficient.

What should a Kesimpta Letter of Medical Necessity include?

Document MS diagnosis, disease activity, MRI findings, prior DMTs, hepatitis B screening, immunoglobulin levels, and rationale for self-administered anti-CD20.

Which payers cover Kesimpta?

Kesimpta is covered by major US payers including UnitedHealthcare, Aetna, Cigna, BCBS, Medicare Part D, though formulary tier and prior authorization criteria vary.

Prior Authorization Guides