neffy (epinephrine nasal spray) — Blue Cross Blue Shield of Kansas
emergency treatment of allergic reactions (Type I) including anaphylaxis
Preferred products
- EpiPen (epinephrine injection)
- EpiPen Jr (epinephrine injection pediatric)
- epinephrine injection (EpiPen generic)
Initial criteria
- Target Agent(s) will be approved when ONE of the following is met:
- 1. The requested agent is neffy AND there is support that BOTH of the preferred agents are not clinically appropriate for the patient OR
- 2. The requested agent is NOT neffy AND there is support that the preferred agents are not clinically appropriate for the patient
Approval duration
12 months