Arikayce — Medical Mutual
Cystic Fibrosis
Initial criteria
- Patient has Pseudomonas aeruginosa in culture of the airway (sputum culture, oropharyngeal culture, or bronchoalveolar lavage culture)
- Medication is prescribed by or in consultation with a pulmonologist or a physician who specializes in the treatment of cystic fibrosis
Approval duration
1 year