RiVive — CareFirst (Caremark)
Emergency therapy in settings where opioids may be present
Initial criteria
- Authorization may be granted when the requested drug is prescribed in the event that emergency treatment of opioid overdose may be needed AND the patient requires more than 2 nasal spray cartons (4 nasal sprays) OR 2 pre-filled syringe cartons (4 pre-filled syringes) OR 4 auto-injector cartons (4 auto-injectors) per month due to ANY of the following: the type of opioid the patient is taking (e.g., buprenorphine, pentazocine, long-acting/extended-release opioids), the patient is living in an area that has a longer wait time for emergency medical assistance, the patient had an overdose episode that required use of the requested drug
Approval duration
6 months