Syndros (dronabinol) oral solution — Highmark
nausea and vomiting associated with cancer chemotherapy
Preferred products
- generic dronabinol capsules
Initial criteria
- age ≥ 18 years
- diagnosis of nausea and vomiting (ICD-10: R11) associated with cancer chemotherapy
- therapeutic failure, contraindication, or intolerance to plan-preferred generic dronabinol capsules
- therapeutic failure, intolerance, or contraindication to two standard of care antiemetic agents per NCCN guidelines
Reauthorization criteria
- prescriber attests that the member has experienced positive clinical response to therapy
Approval duration
12 months