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MHCP Enrolled Providers – Pharmacies
Fee-for-Service PA Criteria Sheet – Egrifta
FDA approved indication
Tesamorelin (Egrifta™) is a growth hormone releasing factor (GRF) analog indicated for the reduction of excess abdominal fat* in HIV-infected patients with lipodystrophy.
Tesamorelin is not indicated for weight loss management; it has a weight neutral effect.
*Defined in clinical trials as 105 cm
MHCP Provider Call Center (651) 431-2700 or 1-800-366-5411
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