Enbrel (etanercept) — CareFirst (Caremark)
Chronic moderate to severe plaque psoriasis (PsO)
Initial criteria
- Age ≥ 4 years
- For moderate to severe disease, member has ≥1 of the following: inadequate response or contraindication/intolerance to previous biologic or targeted synthetic drug (e.g., Sotyktu, Otezla) indicated for plaque psoriasis, or failed topical/systemic therapy per chart documentation
Reauthorization criteria
- Chart notes or medical record documentation of decreased body surface area affected and/or improvement in signs and symptoms
Approval duration
12 months