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The Policy VaultThe Policy Vault

upadacitinibUnited Healthcare

Atopic Dermatitis

Preferred products

  • medium to very-high potency topical corticosteroids
  • topical calcineurin inhibitors
  • Eucrisa
  • systemic atopic dermatitis biologics such as Adbry, Dupixent, Ebglyss, Nemluvio

Initial criteria

  • Diagnosis of moderate-to-severe chronic atopic dermatitis
  • AND One of the following:
  • (a) BOTH of the following:
  • • History of failure, contraindication, or intolerance to two of the following topical therapy classes (document drug, date of trial, and/or contraindication): medium to very-high potency topical corticosteroid, topical calcineurin inhibitor, or Eucrisa (crisaborole)
  • AND • One of the following:
  • a. BOTH of the following: submission of medical records documenting 3 month trial of a systemic drug product for atopic dermatitis (e.g., Adbry, Dupixent, Ebglyss, Nemluvio) AND physician attests patient was not adequately controlled
  • OR b. Physician attests systemic treatment with all FDA-approved chronic atopic dermatitis therapies (Adbry, Dupixent, Ebglyss, Nemluvio) is inadvisable with documented contraindication rationale
  • OR c. Patient has documented needle-phobia (DSM-V-TR 300.29)
  • OR (b) BOTH of the following (continues beyond current chunk)