Fabhalta (iptacopan) — United Healthcare

Initial criteria

• Diagnosis of primary immunoglobulin A nephropathy (IgAN)
• AND
• Patient is at risk of rapid disease progression (e.g., generally a urine protein-to-creatinine ratio [UPCR] ≥1.5 g/g)
• AND
• Used to reduce proteinuria

Reauthorization criteria

• Documentation of positive clinical response to Fabhalta therapy

Approval duration

12 months