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Aetna partners with Novologix to offer free electronic prior authorization services for specialty drugs on Aetna’s National Precertification List. You can use this service for commercial and Medicare members for all health plans. For questions about Novologix, call 1-866-378-3791 or send them an...
Aetna considers continuation of onabotulinumtoxinA (Botox) therapy medically necessary for all members (including new members) requesting reauthorization for an indication listed in Section I.B. (excluding chronic migraine prophylaxis) who meet all initial authorization criteria and are experiencing benefit...
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Aetna considers continuation of hCG therapy medically necessary for all members (including new members) requesting reauthorization who meet all initial authorization criteria. Follitropins (e.g., follitropin alfa [Gonal-f]; follitropin beta [Follistim AQ]) Critieria for Initial Approval: Aetna consi...
Member has met all initial authorization criteria at the time of initial approval;and Member has been evaluated for evidence of amyloid-related imaging abnormalities (ARIA) on MRI prior to the 2nd dose, 3rd dose, 4th dose, and 7th dose (Appendix E); ...
Patients were furthermore required to have a weekly average of nasal congestion score 33 (NCS) greater than 1 prior to randomization, despite use of nasal mometasone. Nasal congestion was measured by a daily assessment on a 0 to 3 point severity scale (0=none, 1=mild, 2=moderate, 3=...
All other indications - all members (including new members) must meet all initial authorization criteria. Lanreotide Acetate Injection (Somatuline Depot, Lanreotide Injection) Criteria for Initial Approval Aetna considers lanreotide acetate injection (Somatuline Depot or Lanreotide Injection) medically necessa...
Intravenous (IV) infusion: 80 mg/4 mL (20 mg/mL), 200 mg/10 mL (20 mg/mL), 400 mg/20 mL (20 mg/mL) in single-dose vials for further dilution prior to IV infusion; Subcutaneous (SC) injection: 162 mg/0.9 mL in a single-dose prefilled syringe or single-dose prefilled auto...
For all members (including new members) requesting authorization for continuation of therapy must meet all initial authorization criteria; All other indications (Avsola/Inflectra/infliximab/Remicade/Renflexis only) For all members (including new members) who are using the requested medication for an indi...