Jynarque (tolvaptan tablets - Otsuka, generic) — Cigna
Autosomal Dominant Polycystic Kidney Disease (ADPKD)
Initial criteria
- Patient age ≥ 18 years; AND
- According to the prescriber, the patient has rapidly progressing autosomal dominant polycystic kidney disease; AND
- At baseline, the patient has an estimated glomerular filtration rate ≥ 25 mL/min/1.73 m2; AND
- Patient is not on renal replacement therapy (defined as dialysis or kidney transplantation); AND
- The medication is prescribed by or in consultation with a nephrologist.
Approval duration
1 year