Joenja — Blue Cross Blue Shield of Montana
members residing in Ohio with other labeled or compendia-supported indications
Initial criteria
- Member resides in Ohio
- Plan is Fully Insured or HIM Shop (SG)
- Patient has no FDA labeled contraindications to the requested agent
- ONE of: (1) patient has another FDA labeled indication and route of administration OR (2) patient has another indication supported in compendia OR (3) prescriber has submitted two peer-reviewed journal articles supporting proposed use as generally safe and effective
Approval duration
12 months