Ebglyss (lebrikizumab-lbkz) — United Healthcare
moderate to severe atopic dermatitis
Initial criteria
- Diagnosis of moderate to severe atopic dermatitis
- History of failure, contraindication, or intolerance to topical therapies
- Patient is not receiving Ebglyss in combination with either of the following:
- Biologic immunomodulator [e.g., Adbry (tralokinumab-ldrm), Dupixent (dupilumab)]
- Janus kinase inhibitor [e.g., Cibinqo (abrocitinib), Opzelura (topical ruxolitinib), Rinvoq (upadacitinib), Xeljanz/XR (tofacitinib)]
Reauthorization criteria
- Documentation of positive clinical response to Ebglyss therapy
- Patient is not receiving Ebglyss in combination with either of the following:
- Biologic immunomodulator [e.g., Adbry (tralokinumab-ldrm), Dupixent (dupilumab)]
- Janus kinase inhibitor [e.g., Cibinqo (abrocitinib), Opzelura (topical ruxolitinib), Rinvoq (upadacitinib), Xeljanz/XR (tofacitinib)]
Approval duration
12 months