Onexton — CareFirst (Caremark)

Initial criteria

• Authorization may be granted when the requested drug is being prescribed for the topical treatment of acne vulgaris.

Reauthorization criteria

• Authorization may be granted when the requested drug is being prescribed for the topical treatment of acne vulgaris AND the patient has achieved or maintained a positive clinical response as evidenced by improvement (e.g., reduction in number of lesions, patient satisfaction, etc.).

Approval duration

Initial therapy: 4 months; Continuation of therapy: 12 months