Itraconazole Sporanox Oral Solution Pa Policy 210 A 03 2023
This policy defines prior authorization coverage criteria for Sporanox (itraconazole) Oral Solution for treatment of oropharyngeal and esophageal candidiasis under Neighborhood Health Plan of Rhode Island (CVS Caremark criteria). It specifies clinical prerequisites (failure, intolerance, or contraindication to fluconazole).
No material changes to clinical coverage criteria or policy content.
Coverage Summary
Coverage stance: covered_with_criteria.
Scope summary: This policy defines prior authorization coverage criteria for Sporanox (itraconazole) Oral Solution for treatment of oropharyngeal and esophageal candidiasis under Neighborhood Health Plan of Rhode Island (CVS Caremark criteria). It specifies clinical prerequisites requiring prior authorization and documentation of either treatment failure, intolerance, or a contraindication to fluconazole before Sporanox oral solution is authorized.
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