Zyvox — CareFirst (Caremark)
Pulmonary tuberculosis resistant to isoniazid and rifampin that is treatment-intolerant or nonresponsive to standard therapy
Initial criteria
- The requested drug is being prescribed as part of a combination regimen with Pretomanid AND Sirturo (bedaquiline).
- The patient will use the requested drug orally or intravenously.
Approval duration
12 months