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CaplytaCareFirst (Caremark)

adjunctive therapy to antidepressants for major depressive disorder

Preferred products

  • aripiprazole
  • asenapine
  • lurasidone
  • olanzapine
  • paliperidone
  • quetiapine
  • quetiapine extended-release
  • risperidone
  • ziprasidone

Initial criteria

  • Authorization may be granted when ONE of the following criteria is met:
  • The patient has experienced an inadequate treatment response, after a trial of at least 30 days, to ONE of the following generic products: aripiprazole, asenapine, lurasidone, olanzapine, paliperidone, quetiapine, quetiapine extended-release, risperidone, ziprasidone.
  • OR the patient has an intolerance or a contraindication that would prohibit a 30-day trial of ONE of those generic products.
  • OR the patient has a clinical condition for which there is no generic alternative or the generic alternatives are not recommended based on published guidelines or clinical literature.

Reauthorization criteria

  • The patient is currently taking the requested drug with evidence of improvement.

Approval duration

36 months