Nafarelin Acetate (Synarel)
Defines medical necessity criteria, initial and continuation approval requirements, dosing limits, approved and non-approved indications, and administrative requirements for coverage of Synarel across HIM/ICHRA and Medicaid lines of business.
2Q 2024 annual review: for endometriosis reduced total treatment duration from 12 to 6 months per prescribing information; clarified bone age requirement and corrected units for basal LH to mIU/mL; references updated.
Added off-label use criteria for gender dysphoria or gender transition (02.16.23 / P&T approval 05.23).
For gender dysphoria and gender transition, added requirement for provider attestation of understanding current State regulations and that care is coverable under State regulations (02.12.25).
For HIM, added requirement that request is for a member in a state other than a listed set where gender dysphoria/gender transition is not covered (02.24.26).
2Q 2026 annual review: added ICHRA line of business; no significant changes to clinical criteria.
4Q 2022 annual review: clarified endometriosis duration and modified continued approval duration from 6 months to up to total treatment duration of 12 months (later changed back per 2Q 2024).
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.