Ziana (clindamycin phosphate 1.2% and tretinoin 0.025% gel – generic) — Cigna

Initial criteria

• For single-entity topical tretinoin products, approve if the individual has acne vulgaris OR the individual is being treated for other non-cosmetic conditions (e.g., acanthosis nigricans, acne rosacea, actinic keratosis/precancerous lesions, alopecia areata, basal cell carcinoma, diabetic foot ulcers, dysplasia of cervix, folliculitis, ichthyosis, keloid scars, keratosis, lichen planus, lichen sclerosis, military osteoma cutis, molluscum contagiosum, mucositis, oral leukoplakia, papillomatosis, systemic sclerosis, or warts).
• For combination topical tretinoin products (Twyneo, Veltin, Ziana), approve if the individual has acne vulgaris.

Approval duration

1 year