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.