Nucala — Medical Mutual
Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome)
Initial criteria
- Patient age ≥ 18 years; AND
- Has active, non-severe disease (vasculitis without life-/organ-threatening manifestations); AND
- Currently receiving systemic corticosteroid (≥ 4 weeks); AND
- Blood eosinophil ≥ 150 cells/µL within previous 6 weeks OR prior to treatment with antibody therapy that may lower eosinophils; AND
- Prescribed by/consult allergist, immunologist, pulmonologist, or rheumatologist
Reauthorization criteria
- Already received ≥ 6 months of Nucala; AND
- Responded to therapy as determined by prescriber (e.g., reduced relapse, corticosteroid dose reduction, reduced eosinophil levels)
Approval duration
6 months initial; 1 year reauth