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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