Uloric — CareFirst (Caremark)
Chronic management of hyperuricemia in adults with gout
Preferred products
- allopurinol
Initial criteria
- Patient is an adult
- Requested drug is for chronic management of hyperuricemia in a patient with gout
- ONE of the following:
- • Patient has experienced an inadequate treatment response to a maximally titrated dose of allopurinol
- • Patient has experienced an intolerance to allopurinol
- • Treatment with allopurinol is contraindicated or inadvisable for the patient
Reauthorization criteria
- Patient has achieved or maintained a positive clinical response since beginning treatment with the requested drug
Approval duration
36 months