Tobramycin Inhalation Solution
Drug - Bethkis, Tobi, tobramycin inhalation solution
January 2018
Therapeutic area - Cystic Fibrosis
Preferred Product: Bethkis inhalation solution
Nonpreferred Products: Tobi, generic tobramycin inhalation solution
Criteria
Authorization will be granted for nonpreferred products if the recipient has had a documented:
- Allergic reaction to a specific inactive ingredient in the preferred product
- Adverse reaction to a specific inactive ingredient in the preferred product
- Therapeutic success while taking the nonpreferred product and therapeutic failure while taking the preferred product
- Supporting documentation must be provided at the time of request
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411