Drizalma Sprinkle (duloxetine) — Highmark
Generalized Anxiety Disorder (GAD)
Initial criteria
- age ≥ 7 years
- diagnosis of GAD (ICD-10: F41.1)
- inability to swallow capsules/tablets
Reauthorization criteria
- prescriber attests member has experienced positive clinical response to therapy
- prescriber attests member continues to have an inability to swallow capsules/tablets
Approval duration
12 months