Rhopressa™
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
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411