Ongentys — Medical Mutual
Parkinson’s disease with hypomobility or 'off' episodes
Initial criteria
- Patient experiences hypomobility or 'off' episodes; AND
- Patient is receiving Ongentys in combination with levodopa/carbidopa; AND
- Patient age ≥ 18 years; AND
- Patient is not concurrently taking a non-selective monoamine oxidase inhibitor (MAOI) (such as: phenelzine, isocarboxazid, etc.); AND
- Patient does not have pheochromocytoma, paraganglioma, or catecholamine secreting neoplasms; AND
- Patient meets ONE of the following criteria (a or b): a) Patient has tried an entacapone product and had significant intolerance OR inadequate efficacy according to the prescriber; OR b) Patient is currently receiving Ongentys; AND
- Ongentys is prescribed by, or in consultation with, a neurologist or prescriber specializing in the treatment of Parkinson’s disease
Reauthorization criteria
- Patient age ≥ 18 years; AND
- Patient is diagnosed with episodes of hypomobility ('off' episodes) associated with Parkinson’s disease; AND
- Patient has experienced a positive clinical response to therapy; AND
- Ongentys is prescribed by, or in consultation with, a neurologist or prescriber specializing in the treatment of Parkinson’s disease
Approval duration
1 year