CurrentCignaPolicy IP0775

Brinsupri (brensocatib) — non‑cystic fibrosis bronchiectasis coverage criteria

Defines Cigna's prior authorization and coverage criteria for Brinsupri for treatment of non-cystic fibrosis bronchiectasis for eligible members (including age and clinical requirements) and who may prescribe it.

Policy Summary

PayerCigna

PolicyBrinsupri (brensocatib) — non‑cystic fibrosis bronchiectasis coverage criteria

Policy CodePolicy IP0775

Change TypeNew policy

Effective Date02/15/2026

Next Review DateN/A

Key ActionObtain prior authorization and ensure the medication is prescribed by or in consultation with a pulmonologist or infectious disease physician.

SourceLink

POLICY UPDATE CHANGES

New policy created for Brinsupri with coverage criteria and prior authorization requirements.

≥12minimum approved patient age

1 yearinitial approval duration

≥2adult exacerbation requirement (12 mo)

≥1adolescent exacerbation requirement (12 mo)

IP0775policy id

Policy Summary

PayerCigna

PolicyBrinsupri (brensocatib) — non‑cystic fibrosis bronchiectasis coverage criteria

Policy CodePolicy IP0775

Change TypeNew policy

Effective Date02/15/2026

Next Review DateN/A

Key ActionObtain prior authorization and ensure the medication is prescribed by or in consultation with a pulmonologist or infectious disease physician.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Coding and Relevant Clinical Thresholds

Covered CPT Codesmixed

No codes listed

Not Covered Codesmixed

No codes listed

Experimental/Investigational Codesmixed

No codes listed

Presumptive Codesmixed

No codes listed

Exacerbation count in prior 12 months — age-specific thresholds

Adolescents (12-17 years)At least 1 pulmonary exacerbation in the prior 12 months resulting in prescription of an antibiotic agent.

Adults (>=18 years)At least 2 pulmonary exacerbations in the prior 12 months resulting in prescription of an antibiotic agent.

Reference timeframeExacerbation count assessed over the prior 12 months.

Prior Authorization, Documentation, and Billing Guidance

Prior Authorization

Prior authorization and prescriber requirement

Prior authorization is required for benefit coverage of Brinsupri. Approvals are provided for the duration noted (typically 1 year) and the medication must be prescribed by or in consultation with a pulmonologist or infectious disease physician.

Step Therapy

Step therapy not required

This policy does not specify any step therapy requirements for Brinsupri.

Documentation Required

Documentation required for criteria

Documentation is required where noted in the criteria (for example, chest computed tomography to document bronchiectasis). Documentation may include chart notes, laboratory tests, claims records, and other patient-specific information and must include patient-identifying information.

Chest computed tomography showing bronchiectasis [documentation required]
Chart notes, laboratory tests, claims records, and/or other patient-specific information

Denial Risk

Coding/claims mismatch will lead to denial

Claims submitted for services that are not accompanied by covered code(s) under the applicable Coverage Policy will be denied as not covered.

Definitions

Pulmonary exacerbation — definition

Core definitionA pulmonary exacerbation is worsening of three or more major respiratory symptoms over 48 hours that results in the prescription of an antibiotic agent.

Major symptoms (examples)Increased cough; increased sputum volume or change in sputum consistency; increased sputum purulence; increased breathlessness; decreased exercise tolerance; fatigue or malaise; hemoptysis.

Required duration of worseningSymptoms worsen over a 48-hour period prior to antibiotic prescription.

Clinical consequenceExacerbation must have resulted in the prescription of an antibiotic agent to meet the policy definition for counting toward eligibility.

Background

Non-cystic fibrosis bronchiectasis is a chronic pulmonary disorder characterized by permanent bronchial dilation on imaging and symptoms such as chronic cough and sputum production. Patients commonly experience recurrent pulmonary exacerbations, often managed with antibiotics and airway clearance strategies.

Brinsupri (brensocatib), a dipeptidyl peptidase 1 (DPP1) inhibitor, is indicated as a novel anti-inflammatory treatment option for this condition in patients aged ≥ 12 years. Clinical use is intended to reduce exacerbation frequency and improve disease-related outcomes when prescribed by or in consultation with a pulmonologist or infectious disease physician.

OpenPayer

Brinsupri (brensocatib) — non‑cystic fibrosis bronchiectasis coverage criteria

Coverage Criteria for Brinsupri (brensocatib)

Coding and Relevant Clinical Thresholds

Prior Authorization, Documentation, and Billing Guidance

Definitions

Background