Voquezna — CareFirst (Caremark)
maintenance of healing of all grades of erosive esophagitis and relief of heartburn associated with erosive esophagitis in adults
Preferred products
- proton pump inhibitor (PPI)
Initial criteria
- Patient age ≥ 18 years
- Patient meets ONE of the following: inadequate treatment response to a one-month trial of a proton pump inhibitor (PPI); intolerance to a PPI; contraindication that would prohibit a trial of a PPI
- Request is for Voquezna 10 mg tablets
Approval duration
6 months