Nucala — Cigna
Hypereosinophilic Syndrome
Initial criteria
- Age ≥ 12 years
- Has had hypereosinophilic syndrome for ≥ 6 months
- FIP1L1-PDGFRα-negative disease
- Does NOT have an identifiable non-hematologic secondary cause of hypereosinophilic syndrome according to the prescriber
- Had blood eosinophil level ≥ 1,000 cells/µL prior to treatment with any monoclonal antibody therapy that may alter blood eosinophil levels
- Tried at least one other treatment for hypereosinophilic syndrome for a minimum of 4 weeks (e.g., systemic corticosteroids, hydroxyurea, cyclosporine, imatinib, pegylated-interferon)
- Prescribed by or in consultation with an allergist, immunologist, pulmonologist, or rheumatologist
Reauthorization criteria
- Has already received at least 8 months of therapy with Nucala
- Responded to therapy as determined by the prescriber (e.g., decreased number of flares, improved fatigue, reduced corticosteroid requirements, decreased eosinophil levels)
Approval duration
initial 8 months, reauth 1 year