Health Net
Vijoice (alpelisib (PROS))
Drugs that Alter Metabolism : Drugs that Alter Metabolism
  • Prior Authorization: PIK3CA-Related Overgrowth Spectrum (PROS):
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Age Requirement: >= 2
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • PIK3CA-Related Overgrowth Spectrum (PROS):
    Age Requirement: >= 2
    Duration: 6 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

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