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ciclopirox — Blue Cross Blue Shield of Oklahoma

rare disease when other labeled or compendia-supported indication present

Initial criteria

  • Request is for a BCBS NM Fully Insured or NM HIM member AND
  • Patient does NOT have any FDA labeled contraindications to the requested agent AND
  • Requested indication is a rare disease AND
  • ONE of the following: (1) Patient has another FDA labeled indication for requested agent and route of administration OR (2) Patient has another indication supported in compendia for requested agent and route of administration