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Vivjoa (oteseconazole) — Blue Cross Blue Shield of Oklahoma

members residing in Ohio (Fully Insured or HIM Shop)

Initial criteria

  • The member resides in Ohio AND the 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 supported in compendia for the requested agent and route of administration OR
  • 3. The prescriber has submitted TWO peer-reviewed journal articles (e.g., JAMA, NEJM, Lancet) supporting the proposed use as generally safe and effective.

Approval duration

12 months