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The Policy VaultThe Policy Vault

Tecfidera (brand)Cigna

multiple sclerosis

Preferred products

  • generic dimethyl fumarate delayed-release capsules

Initial criteria

  • Patient meets BOTH of the following (A and B):
  • A) Patient meets the standard Multiple Sclerosis – Dimethyl Fumarate Prior Authorization Policy criteria; AND
  • B) Patient meets BOTH of the following (i and ii):
  • i. Patient has tried generic dimethyl fumarate delayed-release capsules [documentation required]; AND
  • ii. Patient cannot continue to use generic dimethyl fumarate delayed-release capsules due to a formulation difference in inactive ingredient(s) [e.g., dyes, fillers, preservatives] between the brand and the bioequivalent generic which, per the prescriber, would result in a significant allergy or serious adverse reaction [documentation required].

Approval duration

1 year