Tarpeyo — Blue Cross Blue Shield of Montana
other FDA labeled or compendia-supported indications
Initial criteria
- Member resides in Ohio
- Plan is Fully Insured or HIM Shop (SG)
- No FDA labeled contraindications to Tarpeyo
- The patient has another FDA labeled indication OR indication supported in compendia OR prescriber submitted two peer-reviewed journal articles supporting proposed use as generally safe and effective
Approval duration
12 months