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BethkisCigna

Bronchiectasis, Non-Cystic Fibrosis

Preferred products

  • tobramycin inhalation solution (generic)

Initial criteria

  • Patient meets the standard Antibiotics (Inhaled) – Tobramycin Inhalation Solution Prior Authorization criteria; AND
  • Patient has tried tobramycin inhalation solution (generic)

Approval duration

1 year