2013 Aetna Medicare Prescription Drugs that Require Step Therapy ...

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SOMATOSTATIN ANALOGSProducts AffectedSandostatin Lar DepotSomatuline DepotSomavertDetailsCriteriaA documented trial of one month of generic octreotide9

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ELIDELProducts AffectedElidelDetailsCriteriaA documented trial of two weeks (14 days) of one alternative generictopical corticosteroid8

SOMATOSTATIN ANALOGSProducts AffectedSandostatin Lar DepotSomatuline DepotSomavertDetailsCriteriaA documented trial of one month of generic octreotide9

Page 4: ATYPICAL ANTIPSYCHOTICProducts Affe
Page 7: LIDODERMProducts Affected Lidocaine
Page 11 and 12: SMOKING CESSATIONProducts AffectedC
Page 13: INDEXBBd Insulin Syringe Safetyglid

2013 Aetna Medicare Prescription Drugs that Require Step Therapy ...

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