Eysuvis — CareFirst (Caremark)

Initial criteria

• The requested drug is being prescribed for the treatment of dry eye disease
• The request is for Eysuvis
• The requested drug is being prescribed for short-term use (up to two weeks)

Reauthorization criteria

• All patients (including new patients) requesting authorization for continuation of therapy for Eysuvis must meet ALL requirements in the coverage criteria section

Approval duration

3 months