Anthem Blue Cross (HMO, PPO, EPO)
Firmagon 80 Mg Solr (degarelix)
Drugs for Cancer : Drugs for Cancer
  • Prior Authorization: Documented Diagnosis: Yes

  • Metastatic Prostate Cancer:
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialty Pharmacy Provider(s): 1 of Accredo Health Group, Inc.;Apothecary By Design;Circle Care;The Pharmacy at Maine Medical Center
    Reauthorization Required: No
    Duration of Reauthorization: N/A

    Non-Metastatic Prostate Cancer:
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A