Nemluvio (nemolizumab-ilto) — Point32Health

Initial criteria

• Documented diagnosis of prurigo nodularis as evidenced by one (1) of the following: a) All of the following: i. Presence of firm, nodular lesions; ii. Pruritus lasting at least six weeks; iii. History and/or signs of repeated scratching, picking, or rubbing; or b) Skin biopsy confirming prurigo nodularis
• Patient age ≥ 18 years
• Prescribed by or in consultation with a dermatologist, allergist, or immunologist
• Documentation of one (1) of the following: a) Inadequate response or adverse reaction to Dupixent; b) Contraindication to Dupixent

Reauthorization criteria

• Documented diagnosis of prurigo nodularis
• Patient age ≥ 18 years
• Prescribed by or in consultation with a dermatologist, allergist, or immunologist
• Documentation the patient has experienced a therapeutic response as defined by at least one (1) of the following: a) An improvement in symptoms of prurigo nodularis (e.g., itching); b) Clearing of prurigo nodularis lesions

Approval duration

initial 6 months; reauth 12 months