Grastek — Cigna

Grass pollen-induced allergic rhinitis (with or without conjunctivitis)

Initial criteria

Patient is age ≥ 5 years
AND the timing of prescribing meets ONE of the following:
i. Grastek: Therapy is initiated 12 weeks prior to the expected onset of the grass pollen season OR therapy is being dosed daily continuously for consecutive grass pollen seasons
ii. Oralair: Therapy is initiated 4 months prior to the expected onset of the grass pollen season
AND the diagnosis of grass pollen-induced allergic rhinitis is confirmed by ONE of the following:
i. Patient has a positive skin test response to a grass pollen from the Pooideae subfamily of grasses (e.g., sweet vernal, Kentucky blue grass, Timothy grass, orchard, or perennial rye grass)
ii. Patient has a positive in vitro test for allergen-specific immunoglobulin E antibodies for a grass in the Pooideae subfamily of grasses

1 year