Saxenda — Blue Cross Blue Shield of Oklahoma
other labeled or compendia-supported or rare disease indications (BCBS NM Fully Insured or NM HIM members; Ohio Fully Insured/HIM Shop members)
Initial criteria
- Patient does NOT have FDA‑labeled contraindications to the requested agent
- Requested indication is a rare disease OR another FDA‑labeled indication OR compendia‑supported indication
- For Ohio Fully Insured/HIM Shop members: alternatively, prescriber submitted two peer‑reviewed journal articles supporting proposed use as safe and effective
- Acceptable compendia: DrugDex level 1, 2A, 2B; AHFS‑DI narrative supportive; NCCN 1, 2A for oncology as noted
Approval duration
12 months