Bronchitol (mannitol oral inhalation powder – Pharmaxis/Chiesi) — Cigna

Initial criteria

• Patient is age ≥ 18 years; AND
• Patient has tried hypertonic saline; AND
• Patient has passed the Bronchitol Tolerance Test; AND
• Patient will pre-medicate with a short-acting bronchodilator; AND
• Medication is prescribed by or in consultation with a pulmonologist or a physician who specializes in the treatment of cystic fibrosis

Approval duration

1 year