TOBI Podhaler (tobramycin inhalation powder – Novartis) — Cigna

Initial criteria

• Patient age ≥ 6 years
• Patient has Pseudomonas aeruginosa in culture of the airway (examples: sputum culture, oropharyngeal culture, or bronchoalveolar lavage culture)
• Medication is prescribed by or in consultation with a pulmonologist or a physician who specializes in the treatment of cystic fibrosis

Reauthorization criteria

• Patient was started on TOBI Podhaler and is continuing a course of therapy

Approval duration

initial: 1 year; continuation: 1 month