| Anthem Blue Cross (HMO, PPO, EPO) |
| Vyxeos (daunorubicin-cytarabine lipos) |
| Drugs for Cancer : Drugs for Cancer |
- Prior Authorization: Acute Myeloid Leukemia:
Documented Diagnosis: Yes
Duration: 1 year(s)
- Step Therapy: Acute Myeloid Leukemia:
ST Multiple Generics
- Acute Myeloid Leukemia:
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
Drug Policy Based On: Payer Specific
Quantity Limit: N/A
Diagnosis Types: All FDA-approved indications
Excludes Coverage in Maintenance Setting: No
- Available only through Specialty Pharmacy;
|