Actiq — Point32Health

Initial criteria

• Patient age ≥ 18 years (≥ 16 years if brand name Actiq requested)
• The patient has a diagnosis of breakthrough pain due to cancer
• The patient is currently receiving and is tolerant to at least one or more long-acting opioid analgesics with an average daily dose of at least 30 mg of oxycodone per day, or at least 8 mg of hydromorphone per day, or at least 60 mg of morphine per day, or at least 25 mg of oxymorphone per day, or equianalgesic dose of another opioid

Approval duration

6 months (12 months if sickle-cell, cancer-related, or end-of-life pain)