OXERVATE (cenegermin-bkbj) 

SELF ADMINISTRATION

Indications for Prior Authorization:

  • Treatment of neurotrophic keratitis

Patients must meet the following criteria for the indication(s) above:

  • Diagnosis of neurotrophic keratitis confirmed by chart note documentation, AND
  • Prescribed by or in consultation with an ophthalmologist

Dosing:

  • One drop into the affected eye(s) 6 times per day at 2-hour intervals for 8 weeks

Approval:

  • 8 weeks

Last review date: September 3, 2019