Ctexli (chenodiol tablets – Mirum) — Cigna

Initial criteria

• Diagnosis is established by ONE of the following: (i) molecular genetic test demonstrating a pathogenic variant in the CYP27A1 gene OR (ii) laboratory test demonstrating elevated serum cholestanol levels
• Medication is prescribed by or in consultation with a geneticist, neurologist, ophthalmologist, metabolic specialist who treats patients with cerebrotendinous xanthomatosis, or a specialist who focuses in the treatment of cerebrotendinous xanthomatosis

Approval duration

1 year