Ofev (nintedanib capsules - Boehringer Ingelheim) — Cigna

Initial criteria

• Age ≥ 18 years
• Forced vital capacity ≥ 40% of predicted value
• Diagnosis is confirmed by ONE of the following: Findings on high-resolution computed tomography indicate usual interstitial pneumonia OR Surgical lung biopsy demonstrates usual interstitial pneumonia
• Medication is prescribed by or in consultation with a pulmonologist

Reauthorization criteria

• Age ≥ 18 years
• Patient has experienced a beneficial response to therapy over the last year while receiving Ofev (examples include a reduction in anticipated decline in forced vital capacity, six-minute walk distance, and/or number or severity of exacerbations)
• Medication is prescribed by or in consultation with a pulmonologist

Approval duration

1 year