Therefore, Aetna considers Follistim AQ to be medically necessary only for members who have a contraindication, intolerance, or ineffective response to an adequate one-month trial of the available equivalent alternative Gonal-F (follitropin alfa). There is a lack of reliable evidence that Follistim AQ is superior to other lower cost FSH products for medically necessary indications. Follistim AQ (follitropin beta) is more costly to Aetna than other follicle-stimulating hormone (FSH) products. Brand Selection for Medically Necessary Indications FollitropinsĪs defined in Aetna commercial policies, health care services are not medically necessary when they are more costly than alternative services that are at least as likely to produce equivalent therapeutic or diagnostic results.
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