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and Eastern Cooperative Oncology Group performance status 0 or 1 and then randomly assigned to receive either IL-2 (5 MIU/m2 subcutaneously every 8 hrs for three doses on day 1, then daily 5 days/wk for 4 weeks) and IFN (5 MIU/m2 subcutaneously three times per week for 4 weeks) ever...
Non-Formulary Prior Authorization guideline for Cystic Fibrosis MedicationsTobi Podhaler
American Society of Health-System Pharmacists, Inc. American Hospital Formulary Service Drug Information 98. Bethesda, MD: American Society of Health-System Pharmacists; 1998. Arena Pharmaceuticals. Belviq (lorcaserin hydrochloride) tablets, for oral use. Prescribing Information Zofingen, Switzerland: Arena...
Formulary restrictions may apply. Please check plan benefit description for details. Psychotherapy (if member also exhibits anxiety and/or depression) Psychotherapeutic interventions are covered under the member's behavioral health benefits. Please check benefit plan descriptions. Experimental, Investigational,...
Aetna considers dinutuximab (Unituxin) medically necessary, in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF) [sargramostim (Leukine)], interleukin-2 (IL-2) [aldesleukin (Proleukin)], and 13-cis-retinoic acid (RA) (isotretinoin), for the treatment of high-risk neurobl...