Limited coverage drugs – aripiprazole
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Generic name |
aripiprazole |
---|---|
Strength |
2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg |
Form |
tablet |
Special Authority criteria |
Approval period |
---|---|
Patient specific diagnosis identified as Schizophrenia or other psychosis (not dementia related) AND Treatment failure or intolerance to at least one other specified anti-psychotic agent |
Indefinite |
Practitioner exemptions
- None
Special notes
- Criteria applicable for all plans including Plan G
- Patients who meet Schizophrenia diagnosis criteria for aripiprazole automatically receive coverage for brexpiprazole, olanzapine and ziprasidone