Zyclara (imiquimod) cream 3.75% — Highmark
external genital warts
Preferred products
- generic imiquimod 5% cream
Initial criteria
- age ≥ 12 years
- diagnosis of condyloma acuminata (external genital warts and perianal warts) (ICD-10: A63.0; B07; B07.8)
- therapeutic failure or intolerance to plan‑preferred generic imiquimod 5% cream
Reauthorization criteria
- prescriber attests member has experienced positive clinical response to therapy
- prescriber attests member requires additional courses of treatment
Approval duration
up to 16 weeks