Humira and biosimilars — CareFirst (Caremark)

Initial criteria

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

Reauthorization criteria

• Positive clinical response evidenced by low disease activity or improvement (reduction in abscess/inflammatory nodule count, reduced formation of new sinus tracts and scarring)

Approval duration

12 months