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SaphrisCareFirst (Caremark)

major depressive disorder

Preferred products

  • aripiprazole
  • olanzapine
  • quetiapine
  • risperidone
  • ziprasidone

Initial criteria

  • Diagnosis of schizophrenia OR bipolar disorder OR major depressive disorder must be confirmed by the prescriber
  • Prescriber must document an inadequate response, intolerance, or contraindication to at least two preferred atypical antipsychotic agents

Reauthorization criteria

  • Documentation of clinical benefit from therapy (e.g., improvement or stabilization of symptoms)
  • Absence of unacceptable toxicity or adverse effects

Approval duration

12 months