Eticovo — Medical Mutual

Initial criteria

• Patient age > 18 years
• Patient has tried one systemic corticosteroid OR tried one immunosuppressant ≥ 2 months or was intolerant
• Prescription by or in consultation with dermatologist

Reauthorization criteria

• Patient established on therapy ≥ 4 months
• Beneficial clinical response (improvement in lesion size, depth, number)
• Symptom improvement (pain, tenderness of lesions)

Approval duration

initial 4 months, reauth 1 year