Pancrelipase (Creon, Pancreaze, Pertzye, Viokace, Zenpep) prior authorization
Prior authorization criteria for pancreatic enzyme replacement therapies (pancrelipase products Creon, Pancreaze, Pertzye, Viokace, Zenpep) for treatment of exocrine pancreatic insufficiency due to cystic fibrosis, chronic pancreatitis, pancreatectomy, or other conditions. Specifies a PPI requirement when Viokace is requested.
No material clinical or coverage changes — policy remains current with prior authorization criteria as previously established.
Coverage Summary
Prior authorization is required for pancreatic enzyme replacement therapies (pancrelipase products Creon, Pancreaze, Pertzye, Viokace, and Zenpep) when prescribed for the treatment of exocrine pancreatic insufficiency. Covered indications include exocrine pancreatic insufficiency due to cystic fibrosis, chronic pancreatitis, pancreatectomy, or other conditions.
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