Hemady (dexamethasone) — Highmark
multiple myeloma
Preferred products
- generic dexamethasone
Initial criteria
- age ≥ 18 years
- diagnosis of multiple myeloma (ICD-10 C90)
- use in combination with other anti-myeloma agents
- therapeutic failure or intolerance to generic dexamethasone
Reauthorization criteria
- prescriber attests member is tolerating therapy
- prescriber attests member has experienced a therapeutic response defined as disease improvement OR delayed disease progression
Approval duration
12 months