Humira and biosimilars — CareFirst (Caremark)

Initial criteria

• Age ≥ 18 years
• Member previously received a biologic or targeted synthetic drug (e.g., Sotyktu, Otezla) indicated for moderate to severe plaque psoriasis OR affected crucial body areas (hands, feet, face, neck, scalp, genitals/groin, intertriginous areas) OR ≥10% body surface area affected OR ≥3% body surface area affected AND (inadequate response/intolerance to phototherapy or methotrexate, cyclosporine, or acitretin OR clinical reason to avoid these therapies)

Reauthorization criteria

• Positive clinical response demonstrated by reduction in body surface area affected or improvement in signs/symptoms (itching, redness, flaking, scaling, burning, cracking, pain) compared with baseline

Approval duration

12 months