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Mirvaso (brimonidine) — CareFirst (Caremark)

Rosacea

Initial criteria

  • Patient has a diagnosis of rosacea.

Reauthorization criteria

  • Patient has a diagnosis of rosacea AND has experienced a reduction in symptoms of rosacea from baseline (e.g., inflammatory papules or pustules, facial erythema).

Approval duration

Initial therapy: 4 months; Continuation of therapy: Emrosi 12 months; Finacea, Mirvaso, Noritate, Rhofade, Soolantra 36 months