Leuprolide acetate injection — Medica
Prostate cancer
Preferred products
- Eligard
- Lupron Depot
- Lutrate Depot
- Firmagon
Initial criteria
- Approve for 1 year if the patient meets ONE of the following (A or B):
- A) Patient has tried one of Lutrate Depot, Firmagon, Eligard, or Lupron Depot; OR
- B) If the patient has not tried one of the Preferred Products for prostate cancer: approve one of Lutrate Depot, Firmagon, Eligard, or Lupron Depot.
Approval duration
1 year