- Prior Authorization: Coverage of drugs is first determined by the member's pharmacy benefit. I. FDA Approved Indications: For the treatment of hypertension alone or in combination with other antihypertensive agents. II. Health Net Approved Indications and Usage Guidelines: 1. Failure or clinically significant adverse effects to: a. An angiotensin converting enzyme (ACE) inhibitor followed by a generic angiotensin II receptor blocker (ARB) or ARB combinations (i.e., losartan, candesartan, irbesartan, telmisartan, eprosartan, valsartan); OR b. Two generic ARBs or ARB combinations (i.e., losartan, candesartan, irbesartan, telmisartan, eprosartan, valsartan). III. Authorization Limit: Length of Benefit.
- Step Therapy Exists in PA
- Step Therapy: Step Therapy Exists in PA
- Coverage of drugs is first determined by the member's pharmacy benefit. I. FDA Approved Indications: For the treatment of hypertension alone or in combination with other antihypertensive agents. II. Health Net Approved Indications and Usage Guidelines: 1. Failure or clinically significant adverse effects to: a. An angiotensin converting enzyme (ACE) inhibitor followed by a generic angiotensin II receptor blocker (ARB) or ARB combinations (i.e., losartan, candesartan, irbesartan, telmisartan, eprosartan, valsartan); OR b. Two generic ARBs or ARB combinations (i.e., losartan, candesartan, irbesartan, telmisartan, eprosartan, valsartan). III. Authorization Limit: Length of Benefit.
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