Coxanto — Cigna
treatment of acute and chronic conditions requiring analgesic and anti-inflammatory activity
Preferred products
- diclofenac
- diclofenac sodium
- diclofenac potassium 50 mg tablets
- diclofenac sodium 1.5% topical solution
- diclofenac sodium 1% topical gel
- diclofenac sodium and misoprostol
- etodolac (IR and ER)
- flurbiprofen
- ibuprofen
- indomethacin (IR and ER)
- ketoprofen 50 mg and 75 mg
- ketorolac tablets
- meclofenamate
- mefenamic acid
- meloxicam tablets
- nabumetone
- naproxen
- oxaprozin
- piroxicam
- sulindac
- tolmetin 200 mg
Initial criteria
- Patient has tried and failed two Step 1a NSAID products prior to use of a Step 2a NSAID product
Approval duration
1 year