phentermine/topiramate extended-release (Qsymia, generic) — Medica

Initial criteria

• age ≥ 18 years
• patient has engaged in behavioral modification and dietary restriction for at least 3 months
• patient meets ONE of the following: (a) BMI ≥ 30 kg/m2 OR (b) BMI ≥ 27 kg/m2 AND at least one weight-related comorbidity (hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea, cardiovascular disease, knee osteoarthritis, asthma, chronic obstructive pulmonary disease, metabolic-dysfunction associated steatotic liver disease/nonalcoholic fatty liver disease, polycystic ovarian syndrome, or coronary artery disease)
• medication used concomitantly with behavioral modification and reduced-calorie diet

Reauthorization criteria

• age ≥ 18 years
• patient met BMI criteria at baseline (≥ 30 kg/m2 OR ≥ 27 kg/m2 with comorbidity)
• patient has lost ≥ 5% of baseline body weight
• medication used concomitantly with behavioral modification and reduced-calorie diet

Approval duration

initial 6 months; reauth 1 year