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The Policy VaultThe Policy Vault

Vtama (tapinarof 1% cream)Medica

atopic dermatitis

Preferred products

  • medium-, medium-high, high-, and super-high potency topical corticosteroids including betamethasone dipropionate, augmented; clobetasol propionate; fluocinonide; halobetasol propionate; and other agents per Table 1

Initial criteria

  • A) Plaque psoriasis: Patient meets BOTH of the following (i and ii):
  • i. age ≥ 18 years; AND
  • ii. ONE of the following (a or b):
  • a) Patient has tried one Step 1 Product (medium-, medium-high, high-, or super-high potency prescription topical corticosteroid); OR
  • b) Patient is treating plaque psoriasis and meets ONE of the following (1, 2, or 3):
  • 1. Patient has tried one topical vitamin D analog (e.g., calcipotriene, calcitriol, Sorilux); OR
  • 2. Patient has tried one combination product containing a topical vitamin D analog and topical corticosteroid (e.g., Taclonex, Enstilar, Wynzora); OR
  • 3. Patient is treating plaque psoriasis affecting face, eyes/eyelids, skin folds, and/or genitalia.
  • B) Atopic dermatitis: Patient meets ALL of the following (i, ii, and iii):
  • i. age > 2 years; AND
  • ii. diagnosis of atopic dermatitis; AND
  • iii. ONE of the following (a or b):
  • a) Patient has tried one prescription topical corticosteroid; OR
  • b) Patient is treating atopic dermatitis affecting face, eyes/eyelids, axilla, or genitalia.

Approval duration

1 year