Stendra (avanafil) — United Healthcare
erectile dysfunction
Preferred products
- tadalafil (generic Cialis)
- vardenafil (generic Levitra)
- sildenafil (generic Viagra)
Initial criteria
- Patient has an organic cause of erectile dysfunction (e.g. diabetes mellitus, hypertension, atherosclerosis, drug induced, hypercholesterolemia, renal insufficiency, neurological disease such as stroke, seizure disorder, demyelinating disease, spinal cord injury, tumor; endocrine disorder including hypogonadism; vascular or neurologic disease affecting the genitalia; or history of male genital surgery including prostatectomy, trauma, or irradiation)
- AND Patient is not receiving nitrate therapy
- AND History of failure, contraindication, or intolerance to two of the following (document drug, date tried and reason for failure): tadalafil (generic Cialis), vardenafil (generic Levitra), sildenafil (generic Viagra)
- AND Patient is not concurrently receiving an alternative phosphodiesterase-5 enzyme inhibitor (e.g. Cialis, Levitra, Staxyn, or Viagra)
Approval duration
12 months