BREXAFEMME (ibrexafungerp)

Self-Administration - oral

Indications for Prior Authorization:
  • Indicated for the treatment of adult and post-menarchal pediatric females with vulvovaginal candidiasis (VVC).
Coverage Criteria:

For diagnosis of Vulvovaginal Candidiasis:

  • Dose does not exceed 300 mg (two 150 mg tablets) administered 12 hours apart for one day, AND
  • Trial and failure, contraindication, or intolerance to fluconazole, AND
  • Patient is not pregnant
Coverage Duration:
  • One treatment of 4 tablets
Authorization is not covered for the following:

The use of this drug for indications not listed in this policy does not meet the coverage criteria established by the Western Health Advantage (WHA) Pharmacy and Therapeutics (P&T) Committee.

Additional Information:
  • If specimens for fungal culture are obtained prior to therapy, antifungal therapy may be instituted before the results of the cultures are known. However, once these results become available, antifungal therapy should be adjusted accordingly.
  • Brexafemme® is contraindicated in pregnancy
Policy Updates:
  • 11/16/2021 – New policy approved by P&T.
References:
  • Brexafemme Tablet Prescribing Information. Scynexis, Inc.; Jersey City, NJ. June 2021.
  • Pappas PG, Kauffman CA, Andes DR, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62:e1-50.

 

 

Last review date: November 16, 2021