Hyrimoz — CareFirst (Caremark)

Initial criteria

• Member has moderately to severely active ulcerative colitis

Reauthorization criteria

• Member achieves or maintains remission OR has a positive clinical response with improvement from baseline in any of the following: stool frequency, rectal bleeding, urgency of defecation, C-reactive protein, fecal calprotectin, appearance of mucosa on endoscopy/CTE/MRE/ultrasound, or improvement on disease activity scoring tool (e.g., UCEIS, Mayo score)

Approval duration

12 months