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Alpha 1Proteinase Inhibitors (Ara last/Ara last NP, Prolactin/Prolactin, Demerara, Classic) Prior Authorization Form IF THIS IS AN URGENT REQUEST, Please Call UPMC Health Plan Pharmacy Services. Otherwise,
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Begin filling out the form by providing the necessary medical information. This may include details about your current health condition, previous medical history, and any medications you are currently taking.
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Who needs Glassia - UPMC Health?

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Glassia is a medication used for the treatment of Alpha-1 Antitrypsin Deficiency (AATD). This rare genetic disorder affects the production of a protein called alpha-1 antitrypsin, which can lead to lung and liver problems.
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Individuals diagnosed with AATD may require Glassia as part of their treatment plan. Your healthcare provider will determine if Glassia is necessary based on your specific condition and medical history.
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Glassia - UPMC Health is a health insurance plan offered through a partnership between Glassia and the University of Pittsburgh Medical Center (UPMC).
Individuals who are enrolled in the Glassia - UPMC Health plan are required to file.
To fill out Glassia - UPMC Health, individuals need to provide their personal information, medical history, and any changes in their health status.
The purpose of Glassia - UPMC Health is to provide health insurance coverage for individuals through a partnership between Glassia and UPMC.
Information such as personal details, medical history, and any changes in health status must be reported on Glassia - UPMC Health.
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