Tyrvaya — Blue Cross Blue Shield of Oklahoma

Reauthorization criteria

• Patient has been previously approved for the requested agent through the plan’s Prior Authorization process
• Patient has had clinical benefit with the requested agent
• Patient will NOT be using the requested agent in combination with Verkazia (cyclosporine) or another target agent in this program (e.g., Cequa, Eysuvis, Miebo, Restasis, Tryptyr, Tyrvaya, Vevye, Xiidra)
• Patient does NOT have any FDA labeled contraindications to the requested agent

Approval duration

12 months (BCBSIL); all other plans: Eysuvis 3 months, all other agents 12 months