Dupixent (dupilumab) — United Healthcare
chronic rhinosinusitis with nasal polyposis (CRSwNP)
Initial criteria
- Diagnosis of CRSwNP defined by ≥2 symptoms >12 weeks (nasal discharge, obstruction/congestion, facial pain/pressure/fullness, loss of smell)
- Objective evidence on endoscopy or CT (e.g., purulent mucus or edema in middle meatus/ethmoid, polyps, or radiographic opacification)
- Presence or history of bilateral nasal polyposis
- One of: prior sinus surgery, systemic corticosteroids for CRSwNP in past 2 years, or failure of 2 of: nasal saline irrigations, intranasal corticosteroids, or antileukotriene agents
- Dupixent used as add-on with intranasal corticosteroids
- Not used with anti-IL5, anti-IgE, or TSLP inhibitors
- Prescribed by an Allergist, Immunologist, Otolaryngologist, or Pulmonologist
Reauthorization criteria
- Positive clinical response to Dupixent therapy
- Continued use in combination with intranasal corticosteroids
- Not used with anti-IL5, anti-IgE, or TSLP inhibitors
- Prescribed by an Allergist, Immunologist, Otolaryngologist, or Pulmonologist
Approval duration
12 months