Egrifta SV — Medica
Lipodystrophy associated with human immunodeficiency virus (HIV) infection
Initial criteria
- age ≥ 18 years
- Medication is prescribed for the reduction of excess abdominal fat
- For males, waist circumference ≥ 95 cm and waist-to-hip ratio ≥ 0.94 OR for females, waist circumference ≥ 94 cm and waist-to-hip ratio ≥ 0.88
- Patient has been stable on an antiretroviral regimen for at least 8 weeks
- Medication is prescribed by or in consultation with an endocrinologist or a physician specializing in the treatment of HIV infection (e.g., infectious disease, oncology)
Reauthorization criteria
- Patient is currently receiving Egrifta and has responded as determined by the prescriber, such as reduction in visceral adipose tissue measured by waist circumference or computed tomography (CT) scan
Approval duration
Initial: 6 months; Reauthorization: 1 year