Clindacin PAC — Cigna
acne vulgaris
Preferred products
- adapalene
- azelaic acid
- benzoyl peroxide
- clindamycin
- dapsone
- sulfacetamide
- sulfacetamide/sulfur-containing products
Initial criteria
- Patient has tried one prescription topical acne product (Step 1): brand or generic topical adapalene, azelaic acid, benzoyl peroxide, clindamycin, dapsone, sulfacetamide or sulfacetamide/sulfur-containing product AND one prescription acne cleanser (Step 1): brand or generic topical benzoyl peroxide- or sulfacetamide/sulfur-containing product.
Approval duration
1 year