Ofev (nintedanib capsules) — Cigna

Initial criteria

• Patient is ≥ 18 years of age
• Forced vital capacity is ≥ 40% of the predicted value
• Diagnosis has been confirmed by high-resolution computed tomography or lung biopsy
• According to the prescriber, the patient has clinical signs of progression (examples: forced vital capacity decline ≥ 10% of the predicted value or forced vital capacity decline ≥ 5% to < 10% with worsening symptoms and/or worsening imaging)
• Medication is prescribed by or in consultation with a pulmonologist

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 interstitial lung disease-related exacerbations)
• Medication is prescribed by or in consultation with a pulmonologist

Approval duration

1 year