Nucala — Medical Mutual
Chronic Obstructive Pulmonary Disease (COPD)
Initial criteria
- Patient age ≥ 18 years; AND
- Blood eosinophil level ≥ 300 cells/µL within the previous 6 weeks OR prior to treatment with monoclonal antibody that may lower eosinophil levels; AND
- Received ≥ 3 months of combination therapy with inhaled LABA, inhaled LAMA, and inhaled corticosteroid; OR ≥ 3 months LABA+LAMA if contraindication to inhaled corticosteroid; AND
- ≥ 2 exacerbations requiring systemic corticosteroid ± antibiotic in past 12 months OR ≥ 1 COPD exacerbation requiring hospitalization in past 12 months; AND
- Prescribed by or in consultation with allergist, immunologist, or pulmonologist
Reauthorization criteria
- Already received ≥ 6 months of Nucala therapy; AND
- Continues therapy with inhaled LABA and LAMA; AND
- Beneficial clinical response defined as reduced COPD symptoms OR exacerbations OR hospitalizations OR ED/urgent care visits OR improved lung function
Approval duration
6 months initial; 1 year reauth