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OPTIMA HEALTH COMMUNITY CARE AND OPTIMA FAMILY CARE (MEDICAID) PHARMACY PRIOR AUTHORIZATION/STEPPED REQUEST* Directions: The prescribing physician must sign and clearly print name (preprinted stamps
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01
To fill out drug requested vemurafenib, follow these steps:
02
Obtain the prescription for vemurafenib from a licensed healthcare professional.
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Visit a pharmacy that stocks vemurafenib.
04
Present the prescription to the pharmacist.
05
Provide any necessary personal and insurance information to the pharmacist.
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The pharmacist will dispense the appropriate amount of vemurafenib.
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Follow the instructions provided by the pharmacist and the medication guide.
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Take vemurafenib as directed by your healthcare provider.
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Contact your healthcare provider if you have any questions or concerns.
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Store vemurafenib as instructed, away from heat, light, and moisture.
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Dispose of any unused or expired vemurafenib properly, according to local regulations.

Who needs drug requested vemurafenib?

01
Vemurafenib is a medication used to treat certain types of skin cancer, specifically melanoma, which is caused by a mutation in the BRAF gene.
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Patients who have been diagnosed with unresectable or metastatic melanoma with a BRAF V600 mutation may benefit from vemurafenib.
03
It is important to note that vemurafenib should only be used under the supervision of a healthcare professional who has experience in the treatment of melanoma.
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Vemurafenib is a targeted cancer therapy used primarily for the treatment of melanoma with a specific BRAF mutation.
Healthcare providers, pharmaceutical companies, and research institutions that are involved in the use or investigation of vemurafenib are required to file.
Fill out the drug request form by providing patient details, dosage information, treatment duration, and relevant medical history.
The purpose is to obtain authorization for the use of vemurafenib in eligible patients and to ensure proper monitoring of its safety and efficacy.
Required information includes patient identification, BRAF mutation status, prior treatments, dosage proposed, and any adverse reactions.
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