Klaron — Medica
acne vulgaris
Preferred products
- sodium sulfacetamide/sulfur 10%/5% emollient cream
- generic prescription topical adapalene products
- benzoyl peroxide-containing products
- clindamycin products (excluding generic Clindagel and clindamycin phosphate 1% foam)
- dapsone-containing products
- erythromycin-containing products
- sodium sulfacetamide-containing products
Initial criteria
- Patient has tried one Step 1 Product (sodium sulfacetamide/sulfur 10%/5% emollient cream, generic prescription topical adapalene-, benzoyl peroxide-, clindamycin products other than generic Clindagel and clindamycin phosphate 1% foam, dapsone-, erythromycin-, or sodium sulfacetamide-containing product) within the 130-day look-back period
Approval duration
1 year