WHA

VUITY (pilocarpine)

Self-Administration - ophthalmic solution

 
Diagnosis considered for coverage:

 

  • Presbyopia of the eye - Indicated for the treatment of presbyopia (gradual loss of ability to focus on nearby objects) in adults.
 
Coverage Criteria:

 

For diagnosis of presbyopia:

  • Dose does not exceed one drop to affected eye(s) twice daily; AND
  • Patient is 18 years of age or older; AND
  • Prescribed by or in consultation with an ophthalmologist or optometrist; AND
  • Medical record confirms the patient is unable to use or continue to use corrective lenses (e.g., eyeglasses or contact lenses) for presbyopia.
 
Reauthorization Criteria:

 

For diagnosis of presbyopia:

  • Dose does not exceed one drop to affected eye(s) twice daily; AND
  • Documentation of positive clinical response to therapy (e.g., improvement in near vision in low light conditions without loss of distance vision.
 
Dosing:

 

  • The recommended dosage of VUITY is one drop in each eye once daily. A second dose (one additional drop in each eye) may be administered 3-6 hours after the first dose.
  • If more than one topical ophthalmic product is being used, the products should be administered at least 5 minutes apart.

 

Coverage Duration:

 

  • Initial: 6 months
  • Reauthorization: 1 year
 
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:
  • Contact lens wearers should be advised to remove their lenses prior to the instillation of VUITY and to wait 10 minutes after dosing before reinserting their contact lenses.
  • The most common adverse reactions reported in more than 5% of patients were headache and conjunctival hyperemia (eye redness). Ocular adverse reactions reported in 1-5% of patients were blurred vision, eye pain, visual impairment, eye irritation, and increased lacrimation (tearing).
 
Policy Updates:
  • 05/17/2022 – New policy approved by P&T.
  • 12/01/2023 - Update QL to allow twice daily dosing (P&T 11/14/2023).
 
References:
  1. American Academy of Ophthalmology (AAO). EyeWiki: Presbyopia. December 7, 2021a. https://eyewiki.org/Presbyopia. Accessed December 17, 2021.
  2. American Academy of Ophthalmology (AAO). EyeWiki: Presbyopia treatment. December 7, 2021b. https://eyewiki.org/Presbyopia_Treatment. Accessed December 17, 2021.
  3. American Optometric Association (AOA). Optometric clinical practice guideline. Care of the patient with visual impairment (low vision rehabilitation). 2007. Clinical Practice Guidelines, AOA. Accessed December 17, 2021.
  4. Baitch, L. American Academy of Optometry (AAOpt): Surgical and pharmacological treatment of presbyopia [abstract 63573-PO]. 2019. Surgical and Pharmacological Treatment of Presbyopia (aaopt.org). Accessed December 17, 2021..
  5. ClinicalTrials.gov Web site. https://clinicaltrials.gov. Identifiers: NCT03804268, NCT03857542. Accessed December 1, 2021.
  6. Kaiser PK. Prospective evaluation of visual acuity assessment: a comparison of Snellen versus ETDRS charts in clinical practice (an AOS thesis. Trans Am Ophthalmol Soc. 2009;107:311-324.
  7. Katz JA, Karpecki PM, Dorca A, et al. Presbyopia - a review of current treatment options and emerging therapies. Clin Ophthalmol. 2021;15:2167-2178. doi: 10.2147/OPTH.S259011.
  8. Vuity [package insert], North Chicago, IL: AbbVie Inc.; October 2021.
  9. Waring GO, McCabe C, Wirta D, Safyan E, Guo Q, Robinson MR. GEMINI 1 & 2 pooled phase 3 safety and efficacy: AGN-190584 primary and key secondary endpoints [abstract]. Presented at: AAO; 2021 Nov 12-15; New Orleans, LA.
  10. Wolffsohn JS, Davies LN. Presbyopia: Effectiveness of correction strategies. Prog Retin Eye Res. 2019;68:124-143. doi: 10.1016/j.preteyeres.2018.09.004.

Last review date: December 1, 2023