UnitedHealthcare
Inqovi (decitabine-cedazuridine)
Drugs for Cancer : Drugs for Cancer
  • Prior Authorization: Myelodysplastic Syndrome:
    Documented Diagnosis: Yes
    Duration: 12 Month(s)
    Reauthorization Required: Yes

  • Quantity Limit: Maximum quantity 5 tablets per month.
  • Myelodysplastic Syndrome:
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)