Health Net
Vidaza (azacitidine)
Drugs for Cancer : Drugs for Cancer
  • Step Therapy Applies
  • Prior Authorization: Myelodysplastic Syndrome:
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Myelodysplastic Syndrome:
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): 1 of Hematologist;Oncologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)