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The Policy VaultThe Policy Vault

ToviazBlue Cross Blue Shield of Kansas

Treatment of neurogenic detrusor overactivity (NDO) in pediatric patients as labeled

Preferred products

  • darifenacin
  • oxybutynin chloride
  • trospium chloride
  • tolterodine tartrate

Initial criteria

  • Step therapy applies: patient must have tried and failed or have contraindication to preferred urinary incontinence agents prior to approval of non-preferred agents.