Health Net
Macugen (pegaptanib)
Drugs for the Eye : Drugs for the Eye
  • Step Therapy: Neovascular (Wet) Age-Related Macular Degeneration (AMD):
    ST Single Generic

  • Prior Authorization: Neovascular (Wet) Age-Related Macular Degeneration (AMD):
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Neovascular (Wet) Age-Related Macular Degeneration (AMD):
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 6 month(s)

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