Filspari — Medical Mutual

Primary Immunoglobulin A Nephropathy

Initial criteria

Patient is age ≥ 18 years
Diagnosis has been confirmed by biopsy
Patient is at high risk of disease progression, defined by ALL of the following:
Patient meets ONE of the following: Proteinuria ≥ 0.5 g/day OR Urine protein-to-creatinine ratio ≥ 0.8 g/g
Patient has received the maximum or maximally tolerated dose of ONE of the following for ≥ 12 weeks prior to starting Filspari: Angiotensin converting enzyme inhibitor OR Angiotensin receptor blocker
Patient has received ≥ 3 months of optimized supportive care, including blood pressure management, lifestyle modification, and cardiovascular risk modification, according to the prescriber
Patient has an estimated glomerular filtration rate ≥ 30 mL/min/1.73 m2
Medication will not be used in combination with any renin-angiotensin-aldosterone antagonists (e.g., ACE inhibitors, ARBs), endothelin receptor antagonists, or aliskiren
Medication is prescribed by or in consultation with a nephrologist

Patient is age ≥ 18 years
Diagnosis has been confirmed by biopsy
Patient has had a response to Filspari, according to the prescriber (e.g., reduction in urine protein-to-creatinine ratio from baseline, reduction in proteinuria from baseline)
Patient has an estimated glomerular filtration rate ≥ 30 mL/min/1.73 m2
Medication is not being used in combination with any renin-angiotensin-aldosterone antagonists (e.g., ACE inhibitors, ARBs), endothelin receptor antagonists, or aliskiren
Medication is prescribed by or in consultation with a nephrologist

1 year initial, 1 year reauth