Dupixent (dupilumab) — United Healthcare

moderate-to-severe asthma

Initial criteria

Diagnosis of moderate-to-severe asthma
Asthma classified as uncontrolled/inadequately controlled (poor symptom control, ≥2 systemic corticosteroid bursts, emergency treatment, airflow limitation, or oral corticosteroid dependence)
Eosinophilic phenotype (baseline eosinophil level ≥150 cells/μL) OR oral corticosteroid dependence
Dupixent used in combination with one of the following: (a) maximally dosed combination ICS/LABA [e.g., Advair/AirDuo, Symbicort, Breo Ellipta] OR (b) maximally dosed ICS plus one additional controller (LABA, LTRA, or theophylline)
Not used in combination with anti-IL5 therapy [e.g., Nucala, Cinqair, Fasenra], anti-IgE therapy [e.g., Xolair], or TSLP inhibitor [e.g., Tezspire]
Prescribed by an Allergist, Immunologist, or Pulmonologist

Positive clinical response (reduction in exacerbations, decreased rescue med use, improved FEV1, reduced symptoms, or reduced corticosteroid requirements)
Continued use in combination with an ICS-containing maintenance medication [e.g., Advair/AirDuo, Breo Ellipta, Symbicort, Trelegy Ellipta]
Not used with anti-IL5, anti-IgE, or TSLP inhibitors
Prescribed by an Allergist, Immunologist, or Pulmonologist

12 months