How to Help Your Patients Find Ohtuvayre in Stock: A Provider's Guide

Prescribing Ohtuvayre (ensifentrine) for your COPD patients is only the first step. Getting it into their hands is where many providers — and patients — hit unexpected walls. Ohtuvayre's distribution model is fundamentally different from conventional COPD inhalers, and if your practice hasn't navigated this process before, the specialty pharmacy and prior authorization requirements can create frustrating delays.

This guide is built for pulmonologists, PCPs, and their office teams who want to streamline the Ohtuvayre access pathway for their patients in 2026.

Step 1: E-Prescribe Directly to a Specialty Pharmacy

Ohtuvayre cannot be dispensed at retail pharmacies. Your e-prescription must be routed directly to a specialty pharmacy authorized in the Verona Pathway Plus network. The primary specialty pharmacy for Ohtuvayre is Phyz (NCPDP: 5908809, phone: 844-590-5792).

Note that state-specific e-prescribing laws apply — in New York, for example, prescribers must e-prescribe directly to the dispensing pharmacy. Check your state's requirements and set up Phyz in your EHR's pharmacy directory before attempting to prescribe.

Step 2: Enroll the Patient in Verona Pathway Plus at the Time of Prescribing

Enrollment in Verona Pathway Plus (1-833-372-8492) should happen simultaneously with the prescription — not afterward. Verona Pathway Plus provides:

Benefit verification — checks the patient's insurance coverage before the PA is filed

Prior authorization support — helps compile and submit the necessary clinical documentation

Specialty pharmacy coordination — routes the prescription and checks in with the dispensing pharmacy

Copay card enrollment for commercially insured patients ($0/month eligible)

Patient assistance programs for uninsured and underinsured patients

To enroll a patient, your office can submit a completed Verona Pathway Plus Prescription Form along with front and back copies of the patient's insurance card and relevant clinical documentation (recent chart notes and spirometry results).

Step 3: Submit a Complete Prior Authorization — The First Time

Incomplete prior authorizations are the number one reason patients experience delays. To minimize back-and-forth with the payer, submit the following documents with the initial PA request:

ICD-10 code for COPD (J44.0–J44.9 depending on severity)

Spirometry report: post-bronchodilator FEV1/FVC < 0.7 AND FEV1 ≥ 30% predicted

Recent office visit notes (within 3–6 months) detailing current medications, symptom burden, and rationale for Ohtuvayre

Prior COPD medication history (especially if the plan requires step therapy first)

Reference to the 2025 GOLD guidelines supporting Ohtuvayre as add-on therapy in patients with dyspnea on two long-acting bronchodilators

Step 4: Prepare a Letter of Medical Necessity in Advance

Because a significant proportion of initial PA requests are denied, it's worth preparing a letter of medical necessity (LMN) in parallel — especially for patients whose symptom burden is significant. A strong LMN should:

Describe the patient's COPD severity and functional limitations

Document prior COPD medications tried and their inadequate response

Explain the clinical rationale for Ohtuvayre's unique PDE3/PDE4 mechanism (e.g., need for steroid-sparing anti-inflammatory effect)

Cite ENHANCE trial outcomes: statistically significant FEV1 improvement, improved quality of life scores (E-RS, SGRQ), and exacerbation reduction in ENHANCE-2

Step 5: Help Patients Understand What to Expect

Set realistic expectations with your patients. After the prescription is sent:

The specialty pharmacy will contact them — usually by phone — with important enrollment information

The PA process takes approximately 2–4 weeks

If the PA is approved, the specialty pharmacy will ship Ohtuvayre directly to the patient's home

If denied, your office will be notified for appeal — Verona Pathway Plus will assist with this process

Using medfinder to Help Patients Locate Their Medication

Once the PA is approved and the patient is assigned a specialty pharmacy, occasional issues with stock availability or shipping delays can still arise. Recommending medfinder to your patients can help them quickly find which authorized pharmacy currently has Ohtuvayre in stock. medfinder calls pharmacies on the patient's behalf and texts them the results — reducing the burden on COPD patients who may struggle to spend extended time on the phone.

Monitoring Patients After Starting Ohtuvayre

After initiation, follow up within 4–8 weeks to assess:

Symptom improvement (dyspnea, exercise tolerance, rescue inhaler use frequency)

Any new psychiatric symptoms — insomnia, anxiety, depression, behavioral changes

Proper nebulizer use (patients should shake the ampule before use and use a standard jet nebulizer with mouthpiece)

Confirm they're not mixing Ohtuvayre with other nebulizer solutions and not using it as a rescue treatment

For more background on access challenges, see: Ohtuvayre Access Challenges: What Providers Need to Know in 2026.