Drug: ACCUTANE - Magellan Health Services || TennCare Portal
Drug: ACCUTANE - Magellan Health Services || TennCare Portal
Drug: ACCUTANE - Magellan Health Services || TennCare Portal
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OPHTHALMIC AGENTS<br />
RECOMMENDATION<br />
Cysteamine ophthalmic solution is a new, novel entity that provides a reduction cystine crystalline<br />
accumulation in the cornea of patients diagnosed with Cystinosis. There are currently no other<br />
commercial ophthalmic products used to treat corneal cystine accumulation and systemic<br />
cysteamine therapy has generally proven ineffective in preventing corneal accumulation. Use of<br />
this medication offers patients the possibility of reduced incidence of blindness often experienced<br />
by individuals with the genetic disorder. Therefore, it is recommended Cysteamine ophthalmic<br />
solution should be available for use in patients with Cystinosis.<br />
COMMITTEE VOTE:<br />
APPROVED DISAPPROVED APPROVED with MODIFICATION<br />
PREFERRED<br />
N/A<br />
NEW: CYSTARAN<br />
NON-PREFERRED<br />
CYSTARAN ® (cysteamine hydrocholride)<br />
Prior Authorization Criteria<br />
Cystaran will be approved for patients with a diagnosis of cystinosis.<br />
COMMITTEE VOTE:<br />
APPROVED DISAPPROVED APPROVED with MODIFICATION<br />
References<br />
1. Facts and Comparisons on-line. Version 4.0; Wolters Kluwer <strong>Health</strong>, Inc.; 2013.<br />
Accessed July, 2013.<br />
2. Thompson MICROMEDEX on-line © 1974-2013. Accessed July, 2013.<br />
3. <strong>Magellan</strong> Medicaid Administration. Cystaran New <strong>Drug</strong> Update. May, 2013.<br />
4. Cystaran [package insert]. Gaithersburg, MD; Sigma-Tau Pharmaceuticals; October 2012.<br />
Page 10 of 14<br />
August 13, 2013 Tennessee PAC
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