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PRIOR AUTHORIZATION POLICY Omega-3 Fatty Acid Products omega-3-acid ethyl esters capsules (generic) Lovaza® (omega-3-acid ethyl esters capsules – GlaxoSmithKline) Vascepa® (icosapent ethyl capsules – Amarin) To Ini
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Document Date: 2014-06-02 10:50:50
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PRIOR AUTHORIZATION POLICY Omega-3 Fatty Acid Products omega-3-acid ethyl esters capsules (generic) Lovaza® (omega-3-acid ethyl esters capsules – GlaxoSmithKline) Vascepa® (icosapent ethyl capsules – Amarin) To Ini