Attruby™

Drug - Attruby™ (acoramidis) [BridgeBio Pharma, Inc.]

July 2025

Therapeutic Area - ATTR-Cardiac Amyloidosis (ATTR-CM)

Initial approval criteria

  • Patient is at least 18 years old AND
  • Patient has a diagnosis of cardiomyopathy of wild type or hereditary transthyretin-mediated amyloidosis confirmed by testing (e.g., stannous pyrophosphate [PYP] scanning, monoclonal antibody studies, biopsy, scintigraphy, genetic testing [TTR genotyping]) AND
  • Patient has New York Heart Association (NYHA) Functional Class I, II, or III Heart Failure AND
  • Patient has clinical manifestations of cardiomyopathy (e.g., dyspnea, fatigue, orthostatic hypotension, syncope, peripheral edema) AND
  • The prescriber is a specialist in the area of patient’s diagnosis (e.g., cardiologist, geneticist), or the prescriber has consulted with a specialist in the area of patient’s diagnosis AND
  • Patient will NOT be using Attruby in combination with an RNA-targeted therapy for ATTR amyloidosis [i.e., Amvuttra (vutrisiran), Onpattro (patisiran), Tegsedi (inotersen), Vyndaqel/Vyndamax (tafamadis), or Wainua (eplontersen)] AND
  • Patient does NOT have any FDA labeled contraindications to Attruby.

Renewal criteria

  • Patient has had clinical benefit with Attruby AND
  • Patient has New York Heart Association (NYHA) Functional Class I, II, or III Heart Failure AND
  • The prescriber is a specialist in the area of patient’s diagnosis (e.g., cardiologist, geneticist), or the prescriber has consulted with a specialist in the area of patient’s diagnosis AND
  • Patient will NOT be using Attruby in combination with an RNA-targeted therapy for ATTR amyloidosis [i.e., Amvuttra (vutrisiran), Onpattro (patisiran), Tegsedi (inotersen), Vyndaqel/Vyndamax (tafamadis), or Wainua (eplontersen)] AND
  • Patient does NOT have any FDA labeled contraindications to Attruby

Quantity limits

  • 112 tablets (4 blister cards) per 28 days

Questions

Provider Call Center (844) 575-7887