Anzupgo (delgocitinib) — Highmark
moderate to severe chronic hand eczema (CHE) in adults who have had an inadequate response to, or for whom topical corticosteroids are not advisable
Preferred products
- fluocinolone acetonide 0.025% cream or ointment
- fluticasone propionate 0.05% cream
- hydrocortisone valerate 0.2% cream or ointment
- mometasone furoate 0.1% cream, ointment, or solution
- triamcinolone 0.025% or 0.1% cream, lotion, or ointment
- betamethasone dipropionate 0.05% ointment or cream
- betamethasone valerate 0.1% ointment
- desoximetasone 0.25% cream or ointment
- fluocinonide 0.05% ointment, gel, or solution
- triamcinolone acetonide 0.5% ointment or cream
- betamethasone dipropionate augmented 0.05% ointment
- clobetasol propionate 0.05% cream, foam, gel, ointment
- halobetasol propionate 0.05% cream or ointment
Initial criteria
- age ≥ 18 years
- diagnosis of chronic hand eczema (CHE)
- documentation of one of the following: (1) hand eczema persisting for > 3 months OR (2) hand eczema recurring ≥ 2 times within a 12‑month time frame
- experienced therapeutic failure, contraindication, or intolerance to at least one generic, formulary medium, high, or super‑high potency topical corticosteroid (e.g., clobetasol propionate, betamethasone dipropionate)
Reauthorization criteria
- prescriber attests that the member has experienced positive clinical response to therapy
Approval duration
initial up to 4 months; reauthorization up to 12 months