Wainua (eplontersen) — United Healthcare
polyneuropathy of hereditary transthyretin-mediated amyloidosis (hATTR) in adults
Initial criteria
- Diagnosis of hATTR amyloidosis with polyneuropathy
- AND Patient has a pathogenic TTR mutation (e.g., V30M)
- AND Patient is not receiving Wainua in combination with either of the following:
- (1) Oligonucleotide agents [e.g., Onpattro (patisiran), Amvuttra (vutrisiran), Tegsedi (inotersen)]
- OR (2) Transthyretin stabilizer [e.g., Vyndaqel/Vyndamax (tafamadis), Attruby (acoramidis)]
Reauthorization criteria
- Documentation of positive clinical response to Wainua therapy
- AND Patient is not receiving Wainua in combination with either of the following:
- (1) Oligonucleotide agents [e.g., Onpattro (patisiran), Amvuttra (vutrisiran), Tegsedi (inotersen)]
- OR (2) Transthyretin stabilizer [e.g., Vyndaqel/Vyndamax (tafamadis), Attruby (acoramidis)]
Approval duration
12 months