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The Policy VaultThe Policy Vault

Vfend IV (voriconazole) — CareFirst (Caremark)

Serious fungal infections caused by Scedosporium apiospermum (asexual form of Pseudallescheria boydii) and Fusarium species including Fusarium solani in adults and pediatric patients (age ≥ 2 years) intolerant of, or refractory to, other therapy

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