Western Health Advantage - All plan years |
Oxervate (cenegermin-bkbj) |
Drugs for the Eye : Drugs for the Eye |
- Step Therapy: Derm: Acne Vulgaris:
ST Single Generic
- Orally administered anticancer medication.
- Metastatic Castrate-Sensitive Prostate Cancer (mCSPC):
Age Requirement: >= 18
Duration: 1 plan year
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: No
Specialist Type(s): 1 of Oncologist;Urologist
Reauthorization Required: Yes
Duration of Reauthorization: = 1 plan year
Metastatic Prostate Cancer: Age Requirement: >= 18
Duration: 6 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: No
Specialist Type(s): 1 of Oncologist;Urologist
Reauthorization Required: Yes
Duration of Reauthorization: = 1 plan year
- Quantity Limit: limit maximum 0.02 EA PER 1 day(s)
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