Abrilada — CareFirst (Caremark)

Initial criteria

• Members ≥12 years who have previously received a biologic indicated for moderate to severe hidradenitis suppurativa OR
• Members ≥12 years for treatment of moderate to severe hidradenitis suppurativa when either of the following is met: inadequate response to an oral antibiotic used for HS for at least 90 days (e.g., clindamycin, metronidazole, moxifloxacin, rifampin, tetracyclines) OR intolerance/contraindication to oral antibiotics used for HS

Reauthorization criteria

• Members ≥12 years (including new members) using the medication for moderate to severe hidradenitis suppurativa who achieve or maintain a positive clinical response evidenced by reduction in abscess and inflammatory nodule count from baseline OR reduced formation of new sinus tracts and scarring

Approval duration

12 months