chenodiol — Blue Cross Blue Shield of New Mexico

residents in Ohio under Fully Insured or HIM Shop plans with labeled indication or compendia-supported use or peer-reviewed literature support

Initial criteria

1. Member resides in Ohio
2. Plan is Fully Insured or HIM Shop (SG)
3. The patient does NOT have any FDA labeled contraindications
4. ONE of the following:
A. The patient has another FDA labeled indication for the requested agent and route of administration OR
B. The patient has another indication supported in compendia for the requested agent and route of administration OR
C. The prescriber has submitted TWO articles from major peer-reviewed professional medical journals (e.g., JAMA, NEJM, Lancet) supporting the proposed use(s) as generally safe and effective (case studies not acceptable)

12 months