hydrocortisone — CareFirst (Caremark)
treatment of psoriasis (Bryhali Lotion, clobetasol propionate emollient base cream, clobetasol propionate foam, Clobex Shampoo, Clobex Lotion, Clobex Spray, Derma-Smooth/FS (Scalp) Oil, Impoyz Cream, Lexette Foam, Sernivo Spray, Topicort Spray, Ultravate Lotion)
Initial criteria
- Authorization may be granted when the requested drug is being prescribed for a corticosteroid-responsive dermatosis or condition (e.g., atopic dermatitis, eczema, psoriasis, seborrheic dermatitis) AND the requested drug is NOT being used in a footbath.
Approval duration
6 months