Adbry (tralokinumab-ldrm) — CareFirst (Caremark)

Moderate-to-severe atopic dermatitis

Preferred products

Member age ≥ 12 years
Medication prescribed by or in consultation with a dermatologist or allergist/immunologist
Member has previously received a biologic (e.g., Dupixent, Ebglyss, Nemluvio) or systemic targeted synthetic drug (e.g., Cibinqo, Rinvoq) indicated for moderate-to-severe atopic dermatitis in the past year; OR
Affected body surface area ≥ 10% OR crucial body areas (hands, feet, face, neck, scalp, genitals/groin, intertriginous areas) are affected
AND Member meets one of the following:
Had inadequate treatment response within the past year to a medium- to super-high-potency topical corticosteroid, topical calcineurin inhibitor, topical Janus kinase (JAK) inhibitor, or topical phosphodiesterase-4 (PDE-4) inhibitor
OR Use of medium- to super-high-potency topical corticosteroid, topical calcineurin inhibitor, topical JAK inhibitor, and topical PDE-4 inhibitor is not advisable (e.g., due to contraindications or prior intolerances)
Member will not use the requested medication concomitantly with any other biologic drug or targeted synthetic drug for the same indication

Member age ≥ 12 years (including new members)
Using medication for moderate-to-severe atopic dermatitis
Member has achieved or maintained a positive clinical response as evidenced by low disease activity (clear or almost clear skin) or improvement in signs and symptoms (e.g., redness, itching, oozing/crusting)

Initial: 4 months; Continuation: 12 months