Ganirelix (Organon) — CareFirst (Caremark)
inhibition of premature luteinizing hormone (LH) surges in women undergoing controlled ovarian hyperstimulation
Preferred products
- Cetrotide
- cetrorelix acetate
Initial criteria
- Member is undergoing ovulation induction or assisted reproductive technology (ART)
Reauthorization criteria
- Member continues to meet all requirements in the coverage criteria section (i.e., undergoing ovulation induction or assisted reproductive technology (ART))
Approval duration
12 months