Cresemba (isavuconazole) — Blue Cross Blue Shield of Montana

Reauthorization criteria

• The patient has been previously approved for the requested agent through the plan’s Prior Authorization review process AND
• ONE of the following:
• A. BOTH of the following: 1. The patient has a diagnosis of invasive aspergillosis or invasive mucormycosis AND 2. The patient has continued indicators of active disease (e.g., biomarkers in serum assay, biopsy, microbiologic culture, radiographic evidence) OR
• B. BOTH of the following: 1. The patient has a diagnosis other than invasive aspergillosis or invasive mucormycosis AND 2. There is support for continued use of the requested agent for the requested indication AND
• The patient does NOT have any FDA labeled contraindications to the requested agent

Approval duration

6 months