Yosprala (aspirin and omeprazole) — Highmark
secondary prevention of cardiovascular and cerebrovascular events in patients at risk of developing aspirin associated gastric ulcers
Preferred products
- aspirin + omeprazole
- aspirin + pantoprazole
Initial criteria
- age ≥ 18 years
- appropriate need for secondary prevention of cardiovascular and cerebrovascular events
- member meets ONE of the following: (a) risk of developing aspirin associated gastric ulcers due to age ≥ 55 years OR (b) risk of developing aspirin associated gastric ulcers due to a history of gastric ulcers
- therapeutic failure or intolerance to ALL of the following plan-preferred, generic agents, available separately and taken together: aspirin + omeprazole AND aspirin + pantoprazole
Reauthorization criteria
- prescriber attests that the member has experienced positive clinical response to therapy
- prescriber attests that the member requires additional courses of treatment
Approval duration
12 months