Filspari (sparsentan) — United Healthcare
primary immunoglobulin A nephropathy (IgAN)
Preferred products
- maximally tolerated ACE inhibitor (e.g., captopril, enalapril)
- maximally tolerated ARB (e.g., candesartan, valsartan)
- glucocorticoid (e.g., methylprednisolone, prednisone)
- SGLT2 inhibitor (e.g., Jardiance)
- Vanrafia
Initial criteria
- Diagnosis of primary immunoglobulin A nephropathy (IgAN) confirmed by renal biopsy
- Patient is at risk of disease progression
- Used to slow kidney function decline
- Used to reduce proteinuria
- Estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m2
- Patient is on a maximized stable dose with one of the following prior to initiating therapy: maximally tolerated angiotensin converting enzyme (ACE) inhibitor (e.g., captopril, enalapril) OR maximally tolerated angiotensin II receptor blocker (ARB) (e.g., candesartan, valsartan)
- Use of renin-angiotensin-aldosterone system (RAAS) inhibitors (e.g., ACE inhibitors, ARBs), endothelin receptor antagonists (ERAs) (e.g., Letairis, Opsumit, Tracleer), and Tekturna will be discontinued prior to initiating treatment
- History of failure (after a 30-day trial), contraindication or intolerance to a glucocorticoid (e.g., methylprednisolone, prednisone)
- History of failure (after a 30-day trial), contraindication or intolerance to a SGLT2 inhibitor (e.g., Jardiance)
- History of failure (after a 30-day trial), contraindication or intolerance to Vanrafia
- Prescribed by or in consultation with a nephrologist
Reauthorization criteria
- Documentation of positive clinical response demonstrated by a reduction in proteinuria
Approval duration
12 months