desonide — CareFirst (Caremark)
relief of inflammatory and pruritic manifestations of seborrheic dermatitis (Capex Shampoo, hydrocortisone butyrate solution)
Initial criteria
- Authorization may be granted when the requested drug is being prescribed for a corticosteroid-responsive dermatosis or condition (e.g., atopic dermatitis, eczema, psoriasis, seborrheic dermatitis) AND the requested drug is NOT being used in a footbath.
Approval duration
6 months