Dupixent — CareFirst (Caremark)

Initial criteria

• Member age ≥ 12 years
• Member remains symptomatic despite treatment with up-dosed second-generation H1 antihistamine (e.g., cetirizine, fexofenadine, levocetirizine, loratadine) for at least 2 weeks per EAACI/GA2LEN/EuroGuiDerm/APAAACI guidelines
• Other causes of wheals (hives) and/or angioedema have been evaluated and excluded (including bradykinin-related angioedema, interleukin-1-associated urticarial syndromes, urticarial vasculitis)
• Member has experienced spontaneous onset of wheals (hives), angioedema, or both for at least 6 weeks

Reauthorization criteria

• Member age ≥ 12 years
• Member has experienced a positive clinical response (e.g., improved symptoms, decrease in weekly urticaria activity score [UAS7]) since initiation of therapy

Approval duration

Initial 6 months, Reauthorization 12 months