Vtama (tapinarof) cream — Point32Health
atopic dermatitis
Preferred products
- generic pimecrolimus cream
- generic tacrolimus ointment
- topical corticosteroids
- topical vitamin D analogs
- topical tazarotene
Initial criteria
- Atopic dermatitis: documented diagnosis of atopic dermatitis AND patient age ≥ 2 years AND documentation of inadequate response or adverse reaction to one of the following: generic pimecrolimus cream, generic tacrolimus ointment, or topical corticosteroid OR contraindication to all of the following: generic pimecrolimus cream, generic tacrolimus ointment, or topical corticosteroid
- Plaque psoriasis: documented diagnosis of plaque psoriasis AND patient age ≥ 18 years AND prescribed by or in consultation with a dermatologist AND documentation of trial and failure or inadequate response to one of the following therapies: medium to very high potency topical corticosteroid, topical vitamin D analog, or topical tazarotene OR contraindication to all of the following: topical corticosteroids, topical vitamin D analog, and topical tazarotene
Reauthorization criteria
- Documentation that the patient has shown improvement on the requested medication
Approval duration
12 months