Western Health Advantage
Iressa (gefitinib)
Drugs for Cancer : Drugs for Cancer
  • Derm: Acne Vulgaris:
    Age Requirement: >= 9
    Duration: 3 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 1 plan year
    Limited to non-cosmetic use: No
    Supporting Documentation Requirements: Chart Notes

  • Quantity Limit: limit maximum 6 EA PER 1 day(s)
  • 1;
  • Preventive Drug: Zero copay.