Ziana

Drug - Ziana Gel (clindamycin/tretinoin) 1.2-0.025%

March 2008

Therapeutic Area - Topical Drugs for Acne

Approximate costs

Ziana Gel (clindamycin/tretinoin) 1.2-0.025%

• 30 gm $150.00
• 60 gm $300.00

Approval criteria

Patient has consistent refill history of:

• Tretinoin 0.01% used in combination with a clindamycin topical product AND
• Tretinoin 0.03% used in combination with a clindamycin topical product
• And a separate trial of Differin 0.1% gel or cream

And has not had therapeutic benefit from any of the drug regimens listed above.

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411