Ofev (nintedanib capsules) — Cigna

Initial criteria

• Patient is ≥ 18 years of age
• Forced vital capacity is ≥ 40% of the predicted value
• Diagnosis is confirmed by high-resolution computed tomography
• Medication is prescribed by or in consultation with a pulmonologist or a rheumatologist

Reauthorization criteria

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

Approval duration

1 year