tolvaptan — Medica
autosomal dominant polycystic kidney disease (ADPKD)
Initial criteria
- age ≥ 18 years
- prescriber confirms patient has rapidly-progressing ADPKD (examples include eGFR decline ≥ 3.0 mL/min/1.73 m2 per year or Mayo Classification 1C, 1D, or 1E)
- baseline estimated glomerular filtration rate (eGFR) ≥ 25 mL/min/1.73 m2 prior to treatment with any tolvaptan product
- patient is not on renal replacement therapy (dialysis or kidney transplantation)
- prescribed by or in consultation with a nephrologist
Approval duration
1 year