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Most PA packets ask for the following: A confirmed diagnosis of Gaucher disease type 1, backed by laboratory evidence such as an enzyme assay or genetic testing Clinical notes from the prescriber documenting baseline disease severity The proposed treatment plan, with the intended dose and frequency Evidence that the patient meets the payer’s clinical criteria for enzyme replacement therapy A step therapy attestation, where the plan asks you to show that cheaper alternatives were considered PA denials usually come down to thin clinical documentation rather than the therapy itself
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Canadian buyers must balance quality verification against practical sourcing challenges