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Xolair (omalizumab) prefilled syringeHighmark

Moderate to severe persistent asthma

Initial criteria

  • age ≥ 6 years if prefilled syringe OR age ≥ 12 years if autoinjector
  • diagnosis of moderate to severe persistent asthma (ICD-10: J45.40, J45.50)
  • positive skin test or in vitro reactivity to a perennial aeroallergen
  • baseline IgE ≥ 30 IU/mL
  • history of ≥ 2 asthma exacerbations requiring oral/injectable corticosteroids in past 12 months OR ≥ 1 asthma exacerbation requiring hospitalization in past 12 months
  • inadequate symptom control despite regular treatment with medium- or high-dose inhaled corticosteroids and at least one additional asthma controller (LABA, LTRA, or theophylline), with or without oral corticosteroids, unless intolerant or contraindicated
  • will continue treatment with medium- or high-dose inhaled corticosteroids and at least one additional asthma controller while using Xolair
  • prescriber attests the member is appropriate for self-administration: no history of anaphylaxis AND at least 3 doses administered under healthcare provider guidance with no hypersensitivity reactions
  • prescriber provides documentation: current weight AND pretreatment serum IgE

Reauthorization criteria

  • age ≥ 6 years if prefilled syringe OR age ≥ 12 years if autoinjector
  • prescriber provides documentation: current weight AND pretreatment serum IgE
  • prescriber attests to improvement meeting one of the following: decreased rescue or oral corticosteroid use OR decreased frequency of severe asthma exacerbations OR increased pulmonary function from baseline (e.g., FEV1) OR reduction in asthma-related symptoms (e.g., coughing, fatigue, shortness of breath, sleep disturbance, wheezing)