Tarpeyo — Medical Mutual

Reauthorization criteria

• Patient is ≥ 18 years of age
• The diagnosis has been confirmed by biopsy
• Patient has been receiving the maximum or maximally tolerated dose of ONE of the following for ≥ 90 days: a. Angiotensin converting enzyme inhibitor (ACEi); OR b. Angiotensin receptor blocker (ARB)
• According to the prescriber, the patient has received ≥ 90 days of optimized supportive care, including blood pressure management, lifestyle modification, and cardiovascular risk modification
• Patient has an estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m2
• The medication is prescribed by or in consultation with a nephrologist

Approval duration

up to 10 months total therapy duration (not to exceed 10 consecutive months)