Crenessity (crinecerfont) — CareFirst (Caremark)

Classic congenital adrenal hyperplasia (CAH)

Initial criteria

Member is 4 years of age or older
Diagnosis of classic congenital adrenal hyperplasia (CAH) is confirmed by any of the following: genetic test confirming presence of pathogenic variants in CYP21A2 OR lab tests confirming 21-hydroxylase deficiency [e.g., baseline morning serum 17-hydroxyprogesterone (17-OHP) measurement by LC-MS/MS, cosyntropin (ACTH) stimulation test, adrenal steroid profile]
Member is currently receiving glucocorticoid therapy and stable for at least 1 month
Medication is prescribed by or in consultation with an endocrinologist
No diagnosis of other known forms of CAH (e.g., 11-beta-hydroxylase deficiency, 17-alpha-hydroxylase deficiency)
No history of bilateral adrenalectomy, hypopituitarism, or other condition requiring chronic glucocorticoid therapy

Member has achieved or maintained a positive clinical response to treatment (e.g., reduction in glucocorticoid therapy)

12 months