brand Celebrex capsules — Cigna
any condition for which oral NSAIDs or celecoxib is prescribed including chronic condition and perioperative/perioperative/postoperative period
Preferred products
- Cataflam
- diclofenac potassium
- diclofenac sodium (IR and ER)
- diclofenac sodium and misoprostol
- etodolac (IR and ER)
- fenoprofen
- flurbiprofen
- ibuprofen
- indomethacin (IR and ER)
- ketoprofen IR 50 mg and 75 mg
- ketorolac (tablets)
- meclofenamate
- mefenamic acid
- meloxicam
- nabumetone
- naproxen
- oxaprozin
- piroxicam
- sulindac
- tolmetin
Initial criteria
- Approve for 1 year if the individual meets the following (A and B):
- A) Individual meets one of the following (i, ii, iii, iv, or v):
- i. Individual has tried two Step 1 products (oral NSAIDs) either as prescription products or as over-the-counter (OTC) products at prescription-strength doses, for the current condition; OR
- ii. Individual is currently taking chronic systemic corticosteroid therapy (e.g., prednisone), warfarin, clopidogrel, prasugrel, Brilinta (ticagrelor tablets), Xarelto (rivaroxaban tablets and oral suspension), Pradaxa (dabigatran capsules), Eliquis (apixaban tablets), Savaysa (edoxaban tablets), chronic aspirin therapy, fondaparinux injection, or a low molecular weight heparin product (i.e., enoxaparin injection, Fragmin [dalteparin injection]); OR
- iii. Individual has reduced platelet counts or other coagulation disorders; OR
- iv. Individual is age > 75 years and is using celecoxib for a chronic condition; OR
- v. Individual has had a documented upper gastrointestinal bleed from a duodenal or gastric ulcer; AND
- B) Individual has tried the Step 2 Product (generic celecoxib).
- Approve for 30 days if the individual meets both of the following (A and B):
- A) Individual is using the product during the preoperative/perioperative/postoperative period; AND
- B) Individual has tried the Step 2 Product (generic celecoxib).
Approval duration
1 year for chronic use or 30 days perioperative use