Tazorac (tazarotene 0.05% cream, 0.05% gel, 0.1% cream, 0.1% gel) — Cigna

Initial criteria

• Patient has a diagnosis of acne vulgaris OR plaque psoriasis OR other non-cosmetic condition supported by evidence
• Request is not for cosmetic use (e.g., wrinkles, photo-aged or photo-damaged skin, melasma, etc.)

Approval duration

1 year