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Tryptyr — Blue Cross Blue Shield of Texas

dry eye disease

Reauthorization criteria

  • The patient has been previously approved for the requested agent through the plan’s Prior Authorization process
  • The patient has had clinical benefit with the requested agent
  • The 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)
  • The 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