Vfend IV (voriconazole) — CareFirst (Caremark)
Other deep tissue Candida infections including disseminated infections in skin, abdomen, kidney, bladder wall, and wounds
Initial criteria
- Specimens for fungal culture and other relevant laboratory studies (including histopathology) should be obtained prior to therapy to isolate and identify causative organism(s)
- Therapy may be initiated before culture results are known but must be adjusted once results are available
- Patient must have diagnosis of one of the listed invasive or systemic fungal infections for which Vfend is indicated
Reauthorization criteria
- Continued therapy may be appropriate if there is ongoing infection due to susceptible organisms and patient continues to benefit from treatment