Bronchitol (mannitol) — United Healthcare

Initial criteria

• Diagnosis of cystic fibrosis (CF)
• Used in conjunction with standard CF therapies (e.g., chest physiotherapy, bronchodilators, antibiotics, anti-inflammatory therapy [e.g., ibuprofen, oral/inhaled corticosteroids])
• Patient has passed the Bronchitol Tolerance Test
• age ≥ 18 years

Reauthorization criteria

• Documentation of positive clinical response to Bronchitol therapy

Approval duration

12 months