Korlym (mifepristone 300 mg tablets - Corcept, generic) — Cigna

Endogenous Cushing’s Syndrome

Initial criteria

Patient is age ≥ 18 years; AND
Mifepristone is being used to control hyperglycemia secondary to hypercortisolism in patients who have type 2 diabetes mellitus or glucose intolerance; AND
Patient meets ONE of the following (i, ii, or iii): i) According to the prescriber, the patient is not a candidate for surgery or surgery has not been curative; OR ii) Patient is awaiting surgery for endogenous Cushing’s syndrome; OR iii) Patient is awaiting therapeutic response after radiotherapy for endogenous Cushing’s syndrome; AND
Patient meets ONE of the following (i or ii): i) Patient has tried one of ketoconazole tablets, Metopirone (metyrapone capsules), Lysodren (mitotane tablets), Signifor (pasireotide subcutaneous injection), or Signifor LAR (pasireotide intramuscular injection) for the treatment of endogenous Cushing’s syndrome; OR ii) Patient is currently receiving mifepristone; AND
The medication is prescribed by or in consultation with an endocrinologist or a physician who specializes in the treatment of Cushing’s syndrome.

1 year