Voquezna Tablets — Point32Health

Initial criteria

• Documented diagnosis of one of the following: erosive esophagitis (GERD) of any stage OR heartburn associated with erosive esophagitis (GERD) OR heartburn associated with non-erosive gastroesophageal reflux disease (GERD)
• Patient age ≥ 18 years
• Prescribed by or in consultation with a gastroenterologist
• Previous treatment failure with or contraindication to all of the following: omeprazole AND pantoprazole AND lansoprazole AND rabeprazole

Reauthorization criteria

• Continues to have one of the following after an initial treatment course: erosive esophagitis (GERD) of any stage OR heartburn associated with erosive esophagitis (GERD)
• Patient has responded to an initial treatment and continues to require treatment for maintenance

Approval duration

8 weeks initial; 6 months reauth for erosive esophagitis; 4 weeks for non-erosive gastroesophageal reflux disease