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VoqueznaCareFirst (Caremark)

relief of heartburn associated with non-erosive gastroesophageal reflux disease in adults

Preferred products

  • proton pump inhibitor (PPI)

Initial criteria

  • Patient age ≥ 18 years
  • Patient meets ONE of the following: inadequate treatment response to on-demand or intermittent proton pump inhibitor (PPI) therapy; intolerance to a PPI; contraindication that would prohibit a trial of a PPI
  • Request is for Voquezna 10 mg tablets

Approval duration

4 weeks