Aklief (trifarotene) cream — United Healthcare
acne vulgaris
Preferred products
- Over-the-counter Differin gel
- Tretinoin cream (generic Retin-A)
Initial criteria
- Diagnosis of acne vulgaris
- History of failure, contraindication, or intolerance to ONE of the following: 1) Over-the-counter Differin gel; OR 2) Tretinoin cream (generic Retin-A)
Reauthorization criteria
- Documentation of positive clinical response to therapy
Approval duration
12 months