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Vtama (tapinarof)Highmark

Atopic dermatitis

Initial criteria

  • age ≥ 2 years
  • diagnosis of atopic dermatitis (ICD-10: L20)
  • experienced therapeutic failure, contraindication, or intolerance to one of the following: topical tacrolimus OR topical pimecrolimus

Reauthorization criteria

  • prescriber attests that the member has experienced positive clinical response to therapy