Abrilada — CareFirst (Caremark)

Initial criteria

• Authorization may be granted for treatment of moderately to severely active ulcerative colitis

Reauthorization criteria

• Members (including new members) using the medication for moderately to severely active ulcerative colitis 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: stool frequency, rectal bleeding, urgency of defecation, CRP, fecal calprotectin, mucosal appearance on imaging studies, or improvement on a disease activity scoring tool such as UCEIS or Mayo score

Approval duration

12 months