IL-4 inhibitors — Blue Cross Blue Shield of Illinois

Initial criteria

• Prescriber is a specialist appropriate for indication or consulted with appropriate specialist
• Patient will NOT use requested agent in combination with another immunomodulatory agent OR if used in combination, both of the following: prescribing information does not limit combination AND support for use of combination therapy provided
• Patient does NOT have any FDA labeled contraindications to requested agent

Approval duration

6 to 12 months per plan and indication