Vumerity — Medical Mutual
multiple sclerosis
Preferred products
- generic dimethyl fumarate delayed-release capsules
Initial criteria
- Patient meets the standard Multiple Sclerosis – Vumerity Prior Authorization Policy criteria
- Patient has tried generic dimethyl fumarate delayed-release capsules
- Patient has experienced intolerable gastrointestinal adverse events
- Note: Prior use of Tecfidera with intolerable gastrointestinal adverse events also counts
Approval duration
1 year