First-Progesterone VGS — Highmark

Initial criteria

• The member is female AND is using the product for one of the following: (a) treatment of infertility or prevention of early pregnancy failure in females with corpus luteum insufficiency; (b) as part of an ART treatment program; (c) prophylaxis for preterm delivery

Approval duration

3 months for IVF technique; 6 months for other ART techniques, ovulation induction, hypogonadotropic hypogonadism, and fertility preservation