Filsuvez (birch triterpenes) topical gel — United Healthcare
Wounds associated with junctional epidermolysis bullosa
Initial criteria
- Patient is age ≥ 6 months
- Diagnosis of dystrophic epidermolysis bullosa (DEB) OR junctional epidermolysis bullosa (JEB)
- Patient is not receiving Filsuvez in combination with Vyjuvek (beremagene geperpavec-svdt) on the same wound(s)
Reauthorization criteria
- Documentation of positive clinical response to therapy
- Patient is not receiving Filsuvez in combination with Vyjuvek (beremagene geperpavec-svdt) on the same wound(s)
Approval duration
12 months