Skip to content
The Policy VaultThe Policy Vault

Vevye — Blue Cross Blue Shield of Oklahoma

other FDA labeled indication or compendia-supported indication—Ohio Fully Insured or HIM Shop (SG) members

Initial criteria

  • 1. Member resides in Ohio AND
  • 2. Plan is Fully Insured or HIM Shop (SG) AND BOTH of the following:
  • A. The patient does NOT have any FDA labeled contraindications to the requested agent AND
  • B. ONE of the following:
  • 1. The patient has another FDA labeled indication for the requested agent and route of administration OR
  • 2. The patient has another indication that is supported in compendia for the requested agent and route of administration OR
  • 3. The prescriber has submitted TWO articles from major peer-reviewed medical journals (e.g., JAMA, NEJM, Lancet) supporting the proposed use(s) as generally safe and effective; randomized, double-blind, placebo-controlled clinical trials accepted; case studies not acceptable [journal articles required]