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Drug - Rhopressa™ (netarsudil) [Aerie Pharmaceuticals Inc.]

December 2018

Therapeutic area - Ophthalmics, Glaucoma Agents

Approval criteria

  • Patient must be at least 18 years of age AND
  • Patient has a diagnosis of ocular hypertension or open-angle glaucoma AND
  • Patient has had an adequate trial and failure of a prostaglandin inhibitor AND beta-adrenergic antagonist or is to be used in conjunction with another medication for glaucoma AND
  • Patient must not have had:
    • Previous glaucoma intraocular surgery or glaucoma laser procedure in the affected eye OR
    • Ocular surgery or laser treatment within 3 months prior to initiation AND
  • Patient must not currently have:
    • Ocular infection OR
    • Inflammation OR
    • Blepharitis OR
    • Conjunctivitis OR
    • Ocular Disease

Renewal criteria

  • Patient continues to meet above criteria AND
  • Patient has demonstrated efficacy (e.g., reduction in IOP)

Quantity limits

  • One bottle (2.5 mL fill) per affected eye per 30 days


MHCP Provider Call Center 651-431-2700 or 800-366-5411

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