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mifepristone — CareFirst (Caremark)

control hyperglycemia secondary to hypercortisolism in adult patients with endogenous Cushing’s syndrome who have type 2 diabetes mellitus or glucose intolerance and have failed surgery or are not candidates for surgery

Initial criteria

  • Member has type 2 diabetes mellitus or glucose intolerance
  • Requested drug is being prescribed to control hyperglycemia secondary to hypercortisolism
  • Member has had surgery that was not curative OR member is not a candidate for surgery
  • If the member is able to become pregnant, a negative pregnancy test is required before initiating therapy

Reauthorization criteria

  • Member has achieved or maintained an adequate positive response, or there is improvement in signs and symptoms of the condition

Approval duration

Initial authorization: 6 months; Continuation: 12 months