Tarpeyo (budesonide delayed-release capsules) — United Healthcare

Primary immunoglobulin A nephropathy (IgAN)

Initial criteria

Diagnosis of primary immunoglobulin A nephropathy (IgAN) confirmed by renal biopsy
AND Patient is at risk for disease progression
AND Used to reduce the loss of kidney function
AND Estimated glomerular filtration rate (eGFR) ≥ 35 mL/min/1.73 m2
AND One of the following:
1) Patient is on a stabilized dose and receiving concomitant therapy with one of the following: maximally tolerated angiotensin converting enzyme (ACE) inhibitor (e.g., captopril, enalapril) OR maximally tolerated angiotensin II receptor blocker (ARB) (e.g., candesartan, valsartan)
OR 2) Patient has an allergy, contraindication, or intolerance to ACE inhibitors and ARB
AND History of failure, contraindication or intolerance to a 30-day trial of a glucocorticoid (e.g., methylprednisolone, prednisone)
AND Prescribed by or in consultation with a nephrologist

9 months