Propranolol

Coverage decision

Propranolol requires prior authorization. We may cover it when one or more FDA-approved conditions is accepted on the claim. For off-label anxiety symptoms, we may cover it when:

Criteria for 60-day trial

  • An accepted condition of anxiety with symptoms documented using the Hamilton Rating Scale for Anxiety (HAM-A) or the Generalized Anxiety Disorder Screener (GAD-7),
  • There are no contraindications to the use of propranolol (bronchial asthma, cardiogenic shock, sinus bradycardia and greater than 1st degree block, or known hypersensitivity to propranolol),
  • There is no history of adverse events with previous propranolol use AND,
  • There is no history of congestive heart failure or cardiac arrhythmia.

Criteria for continued coverage

  • There is documented improvement in anxiety symptoms by at least 30% as measured by HAM-A or GAD-7 during the trial,
  • There is no history of adverse events with propranolol use, no contraindications, no congestive heart failure or cardiac arrhythmia AND,
  • Propranolol dose is ≤ 320mg/day.

Upon your request, an additional 30 days is available to allow time to taper.