STS, my words are "omega-3 products" and I get that directly from the document linked by BB. I agree with you and the insurance company is also not saying OTC equivalent to V, they are saying:
"ii.
The patient has tried one over-the-counter (OTC) omega-3 fatty acid product (e.g., fish oil supplements) and has not achieved adequate efficacy according to the prescribing physician. "
Where I was wrong that the patient must either try OTC omega-3's or niacin, fibrates, or a statin, and not necessarily both.
For those between 150 and 500 trigs:
Other Uses with Supportive Evidence
2. Hypertriglyceridemia with Triglyceride (TG) Levels of 150 mg/dL to < 500 mg/dL.
Approve
if the patient meets the following criteria (A and B):
A)
The patient has a fasting baseline (pretreatment) triglyceride (TG) level of 150 mg/dL to < 500
mg/dL; AND
B)
The patient meets one of the following criteria (i or ii):
i.
The patient has tried or is currently receiving, one of the following products: niacin
(immediate-release or extended-release), a fibrate (e.g., gemfibrozil, fenofibrate,
fenofibric acid), or a statin (e.g., atorvastatin, simvastatin); OR
ii.
The patient has tried one over-the-counter (O
TC) omega-3 fatty acid product (e.g., fish
oil supplements) and has not achieved adequate efficacy according to the prescribing
physician.
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