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doxepin tablets (generic Silenor)Point32Health

insomnia characterized by difficulty with sleep maintenance

Preferred products

  • doxepin capsules
  • eszopiclone
  • zaleplon
  • zolpidem tartrate
  • ramelteon

Initial criteria

  • The patient has had a trial of a Step-1 or Step-2 medication within the previous 180 days as evidenced by a previous paid claim under the prescription benefit administered by the plan
  • OR the patient has had previous trial of a Step-1 or Step-2 medication as evidenced by physician documented use
  • OR the patient has a physician documented contraindication or intolerance to all Step-1 medications
  • Note: The plan may cover medications on Step-2 if the patient has received a non-formulary medication containing the same therapeutic ingredient as a lower step agent as evidenced by physician documented use
  • PA required for age ≤ 12 years