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Eysuvis — Blue Cross Blue Shield of Illinois

dry eye disease

Reauthorization criteria

  • The patient has been previously approved for the requested agent through the plan’s Prior Authorization process
  • The patient has had clinical benefit with the requested agent
  • The patient will NOT be using the requested agent in combination with Verkazia (cyclosporine) or another target agent in this program (e.g., Cequa, Eysuvis, Miebo, Restasis, Tryptyr, Tyrvaya, Vevye, Xiidra)
  • The patient does NOT have any FDA labeled contraindications to the requested agent

Approval duration

BCBSIL: 12 months; all other plans – Eysuvis 3 months; all other agents 12 months