Qutenza
Drug - Qutenza (capsaicin 8%) [Acorda Therapeutics]
December 2019
Therapeutic area - Postherpetic neuralgia (PHN)
Approval Criteria
- Patient has diagnosis of postherpetic neuralgia AND
- Patient had a documented therapeutic trial and clinical failure or contraindication with all 5 of the following:
- gabapentin AND
- pregabalin AND
- any generic tricyclic antidepressant AND
- prescription-strength lidocaine patch (requires PA) AND
- morphine CR
Quantity Limits
Billing for Qutenza
Qutenza must be billed on a professional claim using J7336 (buy-and-bill).
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411
