adalimumab products — Medica

Initial criteria

• age > 18 years
• patient has tried one systemic corticosteroid (e.g., prednisone) OR one other immunosuppressant (e.g., mycophenolate mofetil, cyclosporine) for ≥ 2 months or was intolerant
• medication is prescribed by or in consultation with a dermatologist

Reauthorization criteria

• patient has been established on adalimumab therapy for ≥ 4 months
• patient experienced clinical response defined as improvement in size, depth, and/or number of lesions from baseline
• symptom improvement such as decreased pain or tenderness of affected lesions

Approval duration

initial 4 months, reauth 1 year