Vtama — Cigna

plaque psoriasis

Preferred products

Topical Corticosteroids (medium-, medium-high, high-, and/or super-high potency prescription topical corticosteroid)
calcipotriene 0.005% cream (Dovonex, generic)
calcipotriene 0.005% foam
calcipotriene 0.005% ointment
calcipotriene 0.005% solution
calcitriol 3 mcg/g ointment (Vectical, generic)
Sorilux
calcipotriene 0.005% and betamethasone dipropionate 0.064% ointment (Taclonex, generic)
calcipotriene 0.005% and betamethasone dipropionate 0.064% suspension (Taclonex, generic)
Enstilar
Wynzora

Patient meets ONE of the following (A or B):
A) Patient meets BOTH of the following (i and ii):
i. Patient is age ≥ 18 years; AND
ii. Patient meets ONE of the following (a, b, or c):
a) Patient has tried one Step 1a Product and one Step 1b Product; OR
b) Patient has tried one Step 1c Product; OR
c) Patient is treating plaque psoriasis affecting one of the following areas: face, eyes/eyelids, skin folds, and/or genitalia and has tried one Step 1b Product; OR
B) Patient meets ALL of the following (i, ii, and iii):
i. Patient is age > 2 years; AND
ii. Patient is treating atopic dermatitis; AND
iii. Patient meets ONE of the following (a or b):
a) Patient has tried one prescription topical corticosteroid (brand or generic); OR
b) Patient is treating atopic dermatitis affecting an area on or around the face, eyes/eyelids, axilla, or genitalia.

1 year