Anthem Blue Cross (HMO, PPO, EPO)
Vraylar (cariprazine)
Drugs for the Nervous System : Drugs for Severe Mental Disorders
  • Quantity Limit: 1 capsule per 1 day(s).
  • Bipolar:
    Duration: 1 year(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A

    Psychiatry: Schizophrenia:
    Duration: 1 year(s)
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A
    Policy Requires Documentation of Patient Noncompliance to Oral Therapy: No
    Established tolerability to oral formulation: No
    Documented Diagnosis: Yes

  • Prior Authorization: Documented Diagnosis: Yes
    Duration: 1 year(s)

  • Step Therapy: Psychiatry: Schizophrenia:
    ST Multiple Generics