Hydrocortisone Acetate Suppository Step Therapy Policy
Defines step therapy coverage requirements for hydrocortisone acetate suppository products (generic, branded generics, and brand products) for Cigna-administered health benefit plans.
No material clinical or coverage changes in this revision.
Coverage Criteria
Step therapy criteria
Covered when ALL of the following are met
Approvals are provided for 1 year when criteria met
Coverage for hydrocortisone acetate suppository products follows a step therapy approach. Any use that does not meet the Step Therapy criteria for Step 2 products is considered not medically necessary. Specifically, Step 2 products (Anusol-HC 25 mg and Proctocort 30 mg) require documentation that the patient has tried a Step 1 product before coverage will be approved. All approvals are provided for 1 year when criteria are met.
Exceptions to the Step Therapy sequence are not permitted for coverage of Step 2 products. Use of a Step 2 product without a documented trial of a Step 1 product is considered not medically necessary. If the Step Therapy rule is not met at the point of service, coverage will be determined according to the Step Therapy criteria and any other exception is treated as not medically necessary.
Initial Therapy Criteria
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.