Eohilia (budesonide suspension) — CareFirst (Caremark)

Initial criteria

• Patient has a diagnosis of eosinophilic esophagitis (EoE)
• Patient age ≥ 11 years
• Patient has a history of clinical symptoms of esophageal dysfunction (e.g., eating problems, abdominal pain, heartburn, dysphagia, vomiting, food impaction, weight loss) at baseline
• Documentation is required for approval

Reauthorization criteria

• Patient has a diagnosis of eosinophilic esophagitis (EoE)
• Patient age ≥ 11 years
• Patient has achieved or maintained a positive clinical response (e.g., improvement in symptoms of esophageal dysfunction, histologic remission on biopsy)
• Documentation is required for approval

Approval duration

Initial: 6 months; Continuation: 12 months