Xphozah (tenapanor tablets - Ardelyx) — Cigna
Hyperphosphatemia in Chronic Kidney Disease
Preferred products
- sevelamer
- lanthanum
- ferric citrate
- sucroferric oxyhydroxide
- calcium carbonate
- calcium acetate
Initial criteria
- Patient age ≥ 18 years; AND
- Patient has chronic kidney disease (CKD); AND
- Patient has been on maintenance dialysis for ≥ 3 months; AND
- Patient’s serum phosphate level is ≥ 5.5 mg/dL and < 10.0 mg/dL; AND
- Patient meets ONE of the following (i or ii):
- i. Patient meets BOTH of the following (a and b):
- a) Patient has tried at least two phosphate binders; AND
- b) Patient had an inadequate response and/or intolerance to at least two phosphate binders; OR
- ii. Patient meets ONE of the following (a or b):
- a) Patient has a contraindication to at least two phosphate binders; OR
- b) Patient meets BOTH of the following (1 and 2):
- (1) Patient has inadequate response and/or intolerance to at least one phosphate binder; AND
- (2) Patient has a contraindication to at least one phosphate binder; AND
- The medication is prescribed by or in consultation with a nephrologist.
Approval duration
1 year