Provider Alert! Dupixent (dupilumab) Criteria Update

Provider Alert!

Provider Alert! Dupixent (dupilumab) Criteria Update

Date: December 7, 2021

Attention: Primary Care Providers and Pulmonologists

Subject: Dupixent (dupilumab) Criteria Update

Effective Date: October 20, 2021

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action: Effective October 20, 2021, Texas Medicaid revised criteria of the Dupixent (dupilumab).  Dupixent is FDA-approved as an add-on maintenance treatment for individuals 6 years and older with moderate-to-severe eosinophilic phenotype asthma, or with oral corticosteroid dependent asthma.

How this impacts providers: The previous criteria required individuals to be 12 years and older for diagnosis of moderate to severe asthma. The revised criteria omits that step to expand treatment to individuals 6 years and older.

Next steps for providers: Providers need to use updated prior authorization forms and providers should share this update with their staff as well.


  1. Navitus TX Medicaid Prior Authorization Forms

If you have any questions, please email TCHP Pharmacy Department at:

For access to all provider alerts, log into: or

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