Generic Phosphate Binders (sevelamer carbonate packet; lanthanum chewable tablet)
Defines coverage and prior authorization criteria for generic phosphate binders (sevelamer carbonate packet [Renvela] and lanthanum chewable tablet [Fosrenol]) for members of Neighborhood Health Plan of Rhode Island.
No material clinical or coverage changes in this revision.
Coverage Criteria
Initial coverage criteria
Covered when ALL of the following are met
Documentation required
Used to establish prior use for step therapy
Neighborhood does not provide coverage for drugs when used for investigational purposes. Investigational use is defined as use at a dose or for a condition that is not recognized as a medically accepted indication in standard reference compendia (AHFS-DI, DrugDex, Clinical Pharmacology, Lexi-Drugs) or in peer-reviewed published medical literature showing sufficient evidence to support the use.
Coding / Product References
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