HEPLISAV-B (hepatitis B vaccine)

HEPLISAV-B (hepatitis B vaccine)

OFFICE ADMINISTRATION

Indications for Prior Authorization:

• Prevention of infection caused by all known subtypes of Hepatitis B virus in adults 18 years of age and older

Prior Authorization Criteria:

• Patient is 18 years of age or older
• Patient does not have a history of severe allergic reaction (such as anaphylaxis) after a previous dose of any Hepatitis B vaccine or to any component of Heplisav-B, including yeast

Dosing:

• Administer 0.5 mL intramuscularly as a two dose series, the second injection should be administered one month after the initial vaccination

Approval:

• 2 doses