Epiduo — CareFirst (Caremark)

Initial criteria

• Authorization may be granted when the requested drug is being prescribed for the topical treatment of acne vulgaris

Reauthorization criteria

• Authorization may be granted when the requested drug is being prescribed for the topical treatment of acne vulgaris when the patient has achieved or maintained a positive clinical response as evidenced by improvement (e.g., reduction in number of lesions, patient satisfaction, etc.)

Approval duration

Initial therapy: 4 months; Continuation: 12 months