Hyrimoz — CareFirst (Caremark)

Initial criteria

• Member has moderately to severely active Crohn’s disease

Reauthorization criteria

• Member has Crohn’s disease and achieves or maintains remission OR has a positive clinical response with improvement from baseline in any of the following: abdominal pain or tenderness, diarrhea, body weight, abdominal mass, hematocrit, appearance of mucosa on endoscopy/CTE/MRE/ultrasound, or improvement on Crohn’s Disease Activity Index (CDAI) score

Approval duration

12 months