Otezla (apremilast) — Blue Cross Blue Shield of Texas
other FDA labeled or compendia supported or literature supported indications
Initial criteria
- Member resides in Ohio AND plan is Fully Insured or HIM Shop (SG)
- Patient does NOT have any FDA labeled contraindications to the requested agent
- ONE of: patient has another FDA labeled indication and route of administration OR patient has another indication that is supported in compendia (DrugDex level 1, 2A or 2B; AHFS-DI) OR prescriber submitted TWO articles from major peer-reviewed journals (JAMA, NEJM, Lancet, etc.) with acceptable study design supporting use as safe and effective
Approval duration
12 months