| Anthem Blue Cross (HMO, PPO, EPO) |
| Sustol (granisetron) |
| Drugs for the Stomach : Drugs for Vomiting and Nausea |
- Step Therapy: Chemo-induced Nausea and Vomiting (CINV):
ST Multiple Brands
- Chemo-induced Nausea and Vomiting (CINV):
Duration: 1 year(s)
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
NV associated with highly emetogenic cancer chemotherapy (HEC): No
NV associated with moderately emetogenic cancer chemotherapy (MEC): No
Concomitant therapy with Corticosteroid: No
Concomitant therapy with 5-HT3 Antagonist: No
- Prior Authorization: Chemo-induced Nausea and Vomiting (CINV):
Duration: 1 year(s)
|