Anzupgo (delgocitinib 2% cream – LEO) — Cigna

Initial criteria

• Patient is age ≥ 18 years; AND
• Patient has hand eczema that has been present for > 3 months or has returned at least twice in a year after its initial presentation and subsequent clearance; AND
• According to the prescriber, patient has moderate to severe chronic hand eczema; AND
• Patient meets ALL of the following (i, ii, and iii): i. Patient has tried at least one medium-, medium-high, high-, and/or super-high-potency prescription topical corticosteroid; AND ii. This topical corticosteroid was applied daily for at least 28 consecutive days; AND iii. According to the prescriber, inadequate efficacy was demonstrated with this topical corticosteroid therapy; OR
• The medication is prescribed by or in consultation with an allergist, immunologist, or dermatologist.

Approval duration

4 months