Aveed (testosterone undecanoate) — CareFirst (Caremark)

Initial criteria

• Member is a biological male or a person that self identifies as male
• Member age ≥ 18 years
• Member has at least two confirmed low morning serum total testosterone concentrations based on the reference laboratory range or current practice guidelines

Reauthorization criteria

• Member is a biological male or a person that self identifies as male
• Member age ≥ 18 years
• Before the start of therapy, the member had at least two confirmed low morning serum total testosterone concentrations based on the reference laboratory range or current practice guidelines

Approval duration

12 months