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RinvoqMedica

atopic dermatitis

Initial criteria

  • Patient meets ONE of the following (a or b): a) Patient has had at least a 4-month trial of ONE systemic therapy; OR b) Patient has tried at least ONE systemic therapy but was unable to tolerate a 4-month trial
  • The medication is prescribed by or in consultation with an allergist, immunologist, or dermatologist

Reauthorization criteria

  • Patient has been established on therapy for at least 90 days
  • Patient experienced a beneficial clinical response, defined as improvement from baseline in at least one of the following: estimated body surface area affected, erythema, induration/papulation/edema, excoriations, lichenification, and/or decreased requirement for other topical or systemic therapies for atopic dermatitis
  • Compared with baseline, patient experienced an improvement in at least one symptom such as decreased itching

Approval duration

initial 6 months; reauth 1 year