Drugs with new or expanded indication
Drug - Drugs with new or expanded indication
October 2022
Intent
- To ensure that drugs, currently require prior authorization but are FDA-approved for new or expanded indication, are not the first drug used when other safe and effective options exist
- To ensure that the patient is a good candidate to receive benefit from the newly approved drug
Prior authorization criteria for approval of drugs with new or expanded indication
- Drug is restricted to FDA approved indications AND
- Other therapies for the disease state have been tried at a reasonable dose and duration without success (intolerance or ineffectiveness), or there is no existing therapy AND
- Prescribing physician must make a statement of anticipated benefit and defines when efficacy will be reevaluated
Questions?
Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with questions.
