Ermeza solution — Cigna
Pituitary Thyrotropin (Thyroid-Stimulating Hormone, TSH) suppression
Preferred products
- levothyroxine sodium tablets (generics)
Initial criteria
- Patient has tried one Step 1 Product (generic levothyroxine tablets, or brand Synthroid, or another brand of levothyroxine tablets such as Levoxyl); OR
- Patient is unable to swallow or has difficulty swallowing tablets
Approval duration
1 year