avacopan — United Healthcare

Initial criteria

• Diagnosis of severe active ANCA-associated vasculitis
• Disease is one of the following types: granulomatosis with polyangiitis (GPA) OR microscopic polyangiitis (MPA)
• Used as adjunctive treatment in combination with standard therapy (e.g., prednisone, azathioprine, mycophenolate, methotrexate, rituximab, cyclophosphamide)

Reauthorization criteria

• Patient does not show evidence of progressive disease while on Tavneos therapy
• Used as adjunctive treatment in combination with standard therapy (e.g., prednisone, azathioprine, mycophenolate, methotrexate, rituximab, cyclophosphamide)

Approval duration

Initial: 6 months; Reauthorization: 12 months