Varithena

180MG/18ML — Foam

Sclerosing Agent

Also known as: VARITHENA FOAM 180MG/18ML

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 16 hours, 7 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Tier 6 - Non-Preferred Brand Specialty None
NC State Health Plan - 70/30 Standard PPO 2026 Tier 6 - Non-Preferred Brand Specialty None
NC State Health Plan - HDHP 2026 Tier 6 - Non-Preferred Brand Specialty None
Something not right?