Vol. 3 No. 11 (2023)
Reimbursement Recommendations

Setmelanotide (Imcivree)

Published November 3, 2023

Key Messages

  • CADTH recommends that Imcivree be reimbursed by public drug plans for weight management in adult and pediatric patients 6 years of age and older with obesity due to Bardet-Biedl syndrome (BBS) if certain conditions are met.
  • Imcivree should only be covered for patients who are aged 6 years and older and have a clinically or genetically confirmed diagnosis of BBS and obesity.
  • Imcivree should only be reimbursed if prescribed by an endocrinologist, pediatric endocrinologist, and/or specialist in weight management or obesity and the cost of Imcivree is reduced. When first prescribed, Imcivree should only be reimbursed for 26 weeks. Reimbursement may be renewed on a yearly basis for patients who experience a clinically meaningful decrease in body weight or body mass index (BMI).