Prozac — Medica
treatment of mood and anxiety disorders in adults
Preferred products
- generic citalopram tablets
- generic citalopram oral solution
- generic escitalopram tablets
- generic fluoxetine immediate-release capsules
- generic fluoxetine oral solution
- generic fluvoxamine immediate-release tablets
- generic paroxetine HCl immediate-release tablets
- generic sertraline tablets
- generic sertraline oral solution
Initial criteria
- Patient age ≥ 18 years
- AND EITHER of the following Step Therapy criteria is met:
- STANDARD CRITERIA:
- • If the patient has tried one Step 1 Product, approve a Step 2 Product.
- • If the patient is currently taking or has taken Pexeva, Viibryd, or Trintellix at any time in the past and discontinued its use, approve the Product that they have used.
- • If the patient cannot swallow or has difficulty swallowing tablets or capsules, approve generic escitalopram oral solution or generic paroxetine HCl oral suspension.
- • If the patient has suicidal ideation, approve Pexeva, Viibryd, or Trintellix.
- HIGH IMPACT CRITERIA:
- • If the patient has tried two Step 1 Products, approve a Step 2 Product.
- • If the patient is currently taking or has taken Pexeva, Viibryd, or Trintellix at any time in the past and discontinued its use, approve the Product that they have used.
- • If the patient cannot swallow or has difficulty swallowing tablets or capsules, approve generic escitalopram oral solution or generic paroxetine HCl oral suspension.
- • If the patient has suicidal ideation, approve Pexeva, Viibryd, or Trintellix.
Approval duration
1 year