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Endometrin — Cigna

Progesterone supplementation/replacement to achieve or maintain a pregnancy as part of Assisted Reproductive Technology (ART) treatment for infertile women

Preferred products

  • Crinone 8% gel

Initial criteria

  • Approve if the patient meets ONE of the following (A or B):
  • A) Patient has tried Crinone 8% gel [documentation required]; OR
  • B) Patient already started on a course of therapy with Endometrin for progesterone supplementation/replacement to achieve or maintain a pregnancy, approve to complete the current course of therapy.

Approval duration

9 months or timeframe to complete current course of therapy