Emflaza (deflazacort) — United Healthcare
Duchenne muscular dystrophy (DMD)
Preferred products
- prednisone
Initial criteria
- Published clinical evidence shows Emflaza is likely to produce equivalent therapeutic results as other available corticosteroids (e.g., prednisone); therefore, Emflaza is not medically necessary for treatment of Duchenne muscular dystrophy.
- Emflaza is typically excluded from coverage. Tried/Failed criteria may be in place depending on plan specifics.
- State mandates, federal regulatory requirements, and member-specific benefit plan coverage may impact coverage criteria.
Reauthorization criteria
- UnitedHealthcare may approve reauthorization based solely on previous claim/medication history, diagnosis codes (ICD10), and/or claim logic.