Strensiq (asfotase alfa) — Blue Cross Blue Shield of Oklahoma
other FDA labeled indication or compendia-supported use (Ohio Fully Insured or HIM Shop members)
Initial criteria
- The member resides in Ohio
- The plan is Fully Insured or HIM Shop (SG)
- The patient has no FDA labeled contraindications to Strensiq
- ONE of the following:
- • The patient has another FDA labeled indication for the requested agent and route of administration OR
- • The patient has another indication supported in compendia (DrugDex level 1, 2A or 2B; AHFS-DI supportive) OR
- • The prescriber submits two articles from major peer-reviewed medical journals (e.g., JAMA, NEJM, Lancet) supporting the proposed use as generally safe and effective (case studies not acceptable)
Approval duration
12 months