Epsolay — Cigna
Inflammatory lesions of rosacea
Preferred products
- generic azelaic acid gel 15%
- generic ivermectin cream 1%
- generic metronidazole cream 0.75%
- generic metronidazole gel 0.75%
- generic metronidazole gel 1%
- generic metronidazole lotion 0.75%
- Rosadan cream
- Rosadan gel
Initial criteria
- If the patient has tried one Step 1 Product, approve a Step 2 Product.
- Note: Soolantra with DAW 9 (indicating that substitution is allowed by the prescriber but the Plan requests brand) will also count as a Step 1 Product.
Approval duration
1 year