Hadlima — CareFirst (Caremark)

Initial criteria

• Member age ≥12 years
• Previously received a biologic indicated for moderate to severe hidradenitis suppurativa OR inadequate response to an oral antibiotic used for hidradenitis suppurativa for ≥90 days (e.g., clindamycin, metronidazole, moxifloxacin, rifampin, tetracyclines) OR intolerance or contraindication to oral antibiotics used for hidradenitis suppurativa

Reauthorization criteria

• Member age ≥12 years (including new members) using requested medication for moderate to severe hidradenitis suppurativa and achieves or maintains positive clinical response evidenced by low disease activity or improvement in signs and symptoms when any of the following are met: reduction in abscess and inflammatory nodule count from baseline OR reduced formation of new sinus tracts and scarring

Approval duration

12 months