Adbry 150 mg/mL prefilled syringes (tralokinumab-ldrm subcutaneous injection) — Cigna
moderate to severe atopic dermatitis in patients age ≥ 12 years whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable
Initial criteria
- If the patient is initiating therapy, as verified by the absence of claims for Adbry in the past 130 days, approve a one-time override for 6 syringes at retail or 14 syringes at home delivery
Approval duration
30 days (one-time override)