Ragwitek (Short ragweed pollen allergen extract) — United Healthcare

Initial criteria

• Diagnosis of short ragweed pollen-induced allergic rhinitis
• Diagnosis confirmed by ONE of the following: (a) Positive skin test to short ragweed pollen OR (b) in vitro testing for pollen-specific IgE antibodies for short ragweed pollen
• Treatment is started or will be started at least 12 weeks before the expected onset of the short ragweed pollen season

Reauthorization criteria

• Documentation of positive clinical response to Ragwitek therapy

Approval duration

12 months