TOBI — Medica
cystic fibrosis in patients with Pseudomonas aeruginosa
Preferred products
- tobramycin inhalation solution (generics to Bethkis, TOBI, Kitabis Pak)
- TOBI Podhaler
Initial criteria
- Patient meets the standard Prior Authorization Policy criteria for the requested Non-Preferred Product
- Patient has tried at least one Preferred Product (tobramycin inhalation solution [generics to Bethkis, TOBI, or Kitabis Pak] or TOBI Podhaler) OR has a clinical reason why Preferred Product(s) cannot be used
Reauthorization criteria
- Continuation is appropriate based on initial criteria and ongoing need for inhaled tobramycin therapy
Approval duration
1 year