Esbriet (pirfenidone) — Medica

Initial criteria

• age ≥ 18 years
• Forced vital capacity ≥ 40% of the predicted value
• Diagnosis of idiopathic pulmonary fibrosis confirmed by one of the following: findings on high-resolution computed tomography indicating usual interstitial pneumonia OR a surgical lung biopsy demonstrating usual interstitial pneumonia
• Medication is prescribed by, or in consultation with, a pulmonologist

Reauthorization criteria

• age ≥ 18 years
• Patient has experienced a beneficial response to therapy over the last year while receiving Esbriet; examples include a reduction in the anticipated decline in forced vital capacity, six-minute walk distance, and/or a reduction in the number or severity of idiopathic pulmonary fibrosis exacerbations
• Medication is prescribed by, or in consultation with, a pulmonologist

Approval duration

1 year