UnitedHealthcare
Symdeko (tezacaftor-ivacaftor)
Drugs for the Lungs : Drugs for Cystic Fibrosis
  • Quantity Limit: limit maximum 2 EA PER 1 day(s)
  • Cystic Fibrosis (CF):
    Age Requirement: >= 6
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Specialist Type(s): CF Specialist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)
    Documented Mutation in the CFTR Gene: Yes
    Documented Homozygous F508del Mutation in the CFTR Gene: Yes
    Pseudomonas Aeruginosa Culture Required: No
    Baseline FEV1 Value (percent predicted): N/A
    FEV1 ImprovementMaintenance for Reauthorization: Yes
    Liver Function Test Required: No

  • Prior Authorization: Cystic Fibrosis (CF):
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Age Requirement: >= 6
    Duration: 6 Month(s)
    Reauthorization Required: Yes