CurrentNeighborhood Health Plan of Rhode IslandPolicy N/A

Solosec (secnidazole) step therapy

Defines step-therapy requirements and coverage criteria for Solosec (secnidazole) for plan members, including required prior failures and allowed quantity/duration.

Policy Summary

PayerNeighborhood Health Plan of Rhode Island

PolicySolosec (secnidazole) step therapy

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateJun 7, 2019

Next Review DateN/A

Key ActionObtain documentation showing failure of at least two formulary alternatives before requesting authorization for Solosec.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

2required prior formulary alternatives to fail

1 moinitial coverage duration

1 packetquantity limit per treatment

2019-06-07policy effective date

Coverage Criteria

Initial Therapy

Covered when ALL of the following are met:

Initial coverage criteria: Member has failed therapy with at least two formulary alternatives (examples: clindamycin phosphate vaginal cream 2%, metronidazole [tablet or 0.75% vaginal gel], tinidazole).>= 2 prior therapy failures

Examples of alternatives are illustrative, not exhaustive.

Quantity and duration: Initial coverage duration: 1 month; Quantity limit: single 2-gram packet of granules per treatment.single 2-gram packet

Neighborhood Health Plan of Rhode Island does not provide coverage for drugs when used for investigational purposes. A therapy is considered investigational when it is used at a dose or for a condition that is not recognized as a medically accepted indication in standard reference compendia or peer‑reviewed literature (for example, AHFS‑DI, Micromedex DrugDex, Clinical Pharmacology, Lexi‑Drugs, or published medical literature).

Policy Summary

PayerNeighborhood Health Plan of Rhode Island

PolicySolosec (secnidazole) step therapy

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateJun 7, 2019

Next Review DateN/A

Key ActionObtain documentation showing failure of at least two formulary alternatives before requesting authorization for Solosec.

SourceLink

On This Page

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Provider Actions & Requirements

Prior Authorization

Prior Authorization Required

Prior authorization is required before Solosec (secnidazole) will be approved.

Step Therapy

Step Therapy Requirement

Step therapy requirement: member must have failed therapy with at least two formulary alternatives before Solosec will be authorized.

Examples of formulary alternatives: Clindamycin phosphate vaginal cream 2%, metronidazole (oral tablet or vaginal gel 0.75%), tinidazole

Documentation Required

Required Medical Information

Required medical information: documentation must show the member has failed therapy with at least two formulary alternatives prior to approval. Include treatment dates and agents tried.

Documented failure or intolerance to at least two formulary alternatives (examples above)
Clinical notes or chart documentation supporting lack of response or intolerance

Denial Risk

Prior Therapy Documentation Needed

Prior therapy requirement: failure to document prior treatment with at least two formulary alternatives (examples provided) will result in denial of authorization.

Missing or insufficient documentation of prior trials prevents approval

Initial Therapy Criteria

Initial therapy

Initial authorization conditions:

Initial authorization: Member has failed at least two formulary alternatives prior to Solosec use.2 prior failures

Examples listed: clindamycin phosphate vaginal cream 2%, metronidazole (tablet or 0.75% vaginal gel), tinidazole.

Step Therapy Requirements

Requirement	Details
Prior failure of formulary alternatives
Member must have failed therapy with at least two formulary alternatives (examples: clindamycin phosphate vaginal cream 2%; metronidazole — tablet or 0.75% vaginal gel; tinidazole).

Quantity Limits

Solosec (secnidazole) — quantity & duration

DrugSolosec (secnidazole)

Quantity limitsingle 2-gram packet of granules per treatment

Coverage duration (initial)1 month

Formsingle 2-gram packet (granules)

Definitions

Investigational use — definition

DefinitionInvestigational use: therapies used at a dose or for a condition other than those recognized as medically accepted indications in standard compendia or peer‑reviewed literature.

Standard referencesAHFS Drug Information, Thomson Micromedex DrugDex, Clinical Pharmacology, Wolters Kluwer Lexi-Drugs, or peer‑reviewed medical literature

Coverage stanceNeighborhood does not provide coverage for drugs when used for investigational purposes.

Background

Solosec (secnidazole) is addressed in this policy with a step‑therapy requirement. Prior authorization and documentation are required: the member must have failed therapy with at least two formulary alternatives (examples include clindamycin phosphate vaginal cream 2%, metronidazole — tablet or 0.75% vaginal gel — or tinidazole) before Solosec will be authorized. The policy limits initial coverage to 1 month with a quantity limit of a single 2‑gram packet of granules per treatment.