Ohtuvayre (ensifentrine) — Highmark

Chronic obstructive pulmonary disease (COPD)

Preferred products

age ≥ 18 years
Diagnosis of COPD (ICD-10: J41-J44)
Post-bronchodilator FEV1 ≤ 80% predicted
Meets one of the following: modified Medical Research Council dyspnea scale score ≥ 2 OR COPD assessment Test score ≥ 10 OR GOLD group B OR GOLD group E
Inadequate symptom control despite regular treatment for at least 3 months with at least two plan-preferred maintenance COPD controllers (e.g., LABA/LAMA, LAMA/LABA/ICS), unless intolerant of or has contraindications to these agents

Prescriber attests that the member has experienced a reduction in symptoms of COPD OR improvement in exercise tolerance OR delayed disease progression OR reduction in the number of exacerbations

12 months