Fetzima — CareFirst (Caremark)
major depressive disorder (MDD)
Preferred products
- serotonin and norepinephrine reuptake inhibitors (SNRI)
- selective serotonin reuptake inhibitors (SSRI)
- mirtazapine
- bupropion
Initial criteria
- Patient is an adult with major depressive disorder (MDD)
- Patient has experienced an inadequate treatment response, intolerance, or has a contraindication to ANY of the following: a serotonin and norepinephrine reuptake inhibitor (SNRI), a selective serotonin reuptake inhibitor (SSRI), mirtazapine, or bupropion
Approval duration
12 months