Skip to content
The Policy VaultThe Policy Vault

Elidel (pimecrolimus) creamPoint32Health

mild to moderate atopic dermatitis (eczema)

Preferred products

  • formulary topical corticosteroids (any potency)
  • tacrolimus ointment

Initial criteria

  • Patient has a trial of at least one Step-1 formulary topical corticosteroid medication or tacrolimus ointment as evidenced by physician documented use, excluding the use of samples OR physician documented contraindication or intolerance to ALL Step-1 medications
  • For facial or intertriginous psoriasis: patient has diagnosis of mild to moderate atopic dermatitis (eczema) or facial or intertriginous psoriasis AND documentation that patient is not a candidate for medium to high potency corticosteroid therapy (e.g., eyelid dermatitis, facial dermatitis, or dermatitis associated with genital area eruptions) OR has a contraindication to topical corticosteroids