CurrentCignaPolicy N/A

Ip_0044_Coveragepositioncriteria_Osilodrostat

Defines prior authorization, coverage criteria, and duration for Isturisa (osilodrostat tablets) for adults with endogenous Cushing's syndrome (including Cushing's disease) across Cigna-administered health benefit plans, with plan-specific preferred product requirements and prior therapy requirements for certain lines of business.

Policy Summary

PayerCigna

PolicyIp_0044_Coveragepositioncriteria_Osilodrostat

Policy CodePolicy N/A

Change TypeCriteria additions, moves, and preferred product clarifications

Effective DateAug 1, 2024

Next Review Date

Key ActionPrior Authorization is required for Isturisa; document diagnosis and ensure prescription is by or in consultation with an endocrinologist, and meet plan-specific prior therapy requirements.

SourceLink

POLICY UPDATE CHANGES

Patients awaiting surgery and patients awaiting therapeutic response after radiotherapy were added as options for approval under endogenous Cushing's syndrome.

Endogenous Cushing's Syndrome was moved from 'other uses with supportive evidence' to 'FDA-approved indication'.

Cushing's Disease condition entry was removed from the policy as a separate item and falls under the broader term Cushing's Syndrome.

Preferred product / prior therapy criteria clarified for Employer and Individual & Family plans (specific alternative therapies listed).

Multiple minor diagnostic requirement updates and 'no criteria changes' notations across dates (including 04/09/2026 and 05/01/2026).

1FDA-approved indications covered