praziquantel — CareFirst (Caremark)

Initial criteria

• The infection has been confirmed by a diagnostic or laboratory test (e.g., imaging scans, scotch tape test, blood, stool, or urine test)
• Request is for praziquantel (Biltricide) in a patient age ≥ 1 year for the treatment of schistosomiasis, clonorchiasis, or opisthorchiasis for ANY of the following: quantity up to 36 tablets, a second day or course of therapy (first course of therapy administered within the past year)

Approval duration

1 month