Odactra — Medical Mutual
Allergen-induced allergic rhinitis with or without conjunctivitis due to house dust mite
Initial criteria
- Positive skin test response OR positive in vitro test for allergen-specific IgE antibodies to house dust mite allergen extracts
- Age ≥ 12 years AND age < 65 years
- Medication is prescribed by or in consultation with an allergist, immunologist, or otolaryngologist (ENT) physician specialist
- Patient has tried and failed nasal or oral antihistamines AND nasal or oral corticosteroids
- First dose will be given under the supervision of a physician with experience in diagnosing and treating severe allergic reactions
- Epinephrine rescue auto-injection is available to patient at home
- None of the following are present: severe, unstable, or uncontrolled asthma; history of any severe systemic or severe local reaction to sublingual allergen immunotherapy; history of eosinophilic esophagitis
Reauthorization criteria
- Response to therapy is required for continuation of therapy
Approval duration
1 year