EpiPen — Medica
emergency treatment of severe allergic reactions (Type I) including anaphylaxis to stinging and biting insects, allergen immunotherapy, foods, drugs, diagnostic testing substances, and other allergens, as well as anaphylaxis to unknown substances and exercise-induced anaphylaxis
Preferred products
- epinephrine auto-injector 0.15 mg (generic to EpiPen Jr.)
- epinephrine auto-injector 0.3 mg (generic to EpiPen)
Initial criteria
- Patient has tried one Step 1 Product (epinephrine auto-injector 0.15 mg or 0.3 mg, generic to EpiPen/EpiPen Jr.)
Approval duration
1 year