Sandostatin® LAR Depot (octreotide acetate) for Injectable Suspension and Sandostatin® (octreotide acetate) Injection

Covered only for the FDA‑approved non‑oncology indication of acromegaly (not for other uses), with approvals up to 12 months. Requires baseline IGF‑1 above the lab‑specific upper limit of normal, endocrinologist prescribing/consult, documentation of prior surgery/radiotherapy failure or ineligibility (or tumor mass effects), and adherence to specified initial/maintenance dosing and monitoring (GH/IGF‑1 and symptoms) with dose adjustments per criteria and a recommended maximum of 40 mg every 4 weeks.

"Treatment of acromegaly in individuals who have had an inadequate response to surgery and/or radiotherapy, or for whom surgery and/or radiotherapy, is not an option."

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