diclofenac sodium topical gel 1% — CareFirst (Caremark)

Initial criteria

• Patient has osteoarthritis pain in joints amenable to topical treatment, such as feet, ankles, knees, hands, wrists, or elbows

Reauthorization criteria

• Patient has osteoarthritis pain in joints amenable to topical treatment, such as feet, ankles, knees, hands, wrists, or elbows
• Patient has achieved or maintained a positive clinical response to the requested drug
• Patient has been re-evaluated periodically to determine if treatment is still necessary

Approval duration

Initial therapy: 4 months; Continuation of therapy: 36 months