Parameters for coverage
Approved when FDA-approved inhalation solutions of the following drugs is necessary.
For patients with:
Obstructive pulmonary disease
- Albuterol, Arformoterol, Budesonide, Cromolyn, Formoterol, Ipratropium, Levalbuterol, Metaproterenol
Cystic fibrosis
- Dornase alpha
Cystic fibrosis or bronchiectasis
- Tobramycin
HIV, Pneumocystosis, or organ transplant complications
- Pentamidine
Persistent thick or tenacious pulmonary secretions
- Acetylcysteine