Abrilada — CareFirst (Caremark)

Initial criteria

• Authorization may be granted for treatment of moderately to severely active Crohn’s disease

Reauthorization criteria

• Members (including new members) using the medication for moderately to severely active Crohn’s disease who achieve or maintain remission OR demonstrate low disease activity or improvement in signs and symptoms with improvement in any of the following from baseline: abdominal pain or tenderness, diarrhea, body weight, abdominal mass, hematocrit, mucosal appearance on imaging studies, or improvement on a disease activity scoring tool such as CDAI

Approval duration

12 months