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Isturisa (osilodrostat)CareFirst (Caremark)

endogenous hypercortisolism in adult patients with Cushing’s syndrome for whom pituitary surgery is not an option or has not been curative

Initial criteria

  • Diagnosis of Cushing’s syndrome/disease
  • Member has had surgery that was not curative OR is not a candidate for surgery
  • Pretreatment cortisol level documented by one of the following tests: Urinary free cortisol (UFC), Late-night salivary cortisol (LNSC), 1 mg overnight dexamethasone suppression test (DST), or Longer, low dose DST (2 mg per day for 48 hours)

Reauthorization criteria

  • Lower cortisol levels since the start of therapy per one of the following tests: Urinary free cortisol (UFC), Late-night salivary cortisol (LNSC), 1 mg overnight dexamethasone suppression test (DST), or Longer, low dose DST (2 mg per day for 48 hours)
  • OR Improvement in signs and symptoms of the disease

Approval duration

initial: 6 months; continuation: 12 months