Inbrija — Medical Mutual

Initial criteria

• Inbrija is prescribed by or in consultation with a neurologist
• The patient is currently taking carbidopa-levodopa
• The patient has previously tried one of: entacapone, rasagiline, pramipexole, ropinirole, tolcapone, Apokyn, cabergoline, selegiline, or Xadago for the treatment of 'off' episodes
• Patient does not have asthma, chronic obstructive pulmonary disease (COPD), or other chronic underlying lung disease

Reauthorization criteria

• Response to therapy is required for continuation of therapy

Approval duration

365 days