Provider Alert! Dupixent Clinical Prior Authorization Criteria Revision
Date: January 26, 2021
Attention: PCPs, Allergists, Pulmonologists, and Dermatologists
Effective Date: March 15, 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 March 15, 2021, Texas Medicaid will revise criteria of the Dupixent (dupilumab) clinical prior authorization. This is only applicable to medications dispensed by retail or specialty pharmacies through the pharmacy benefit. Dupixent is FDA-approved for atopic dermatitis as well as moderate-to-severe eosinophilic or oral steroid dependent asthma.
How this impacts providers: The current criteria require a trial with a topical corticosteroid and a topical calcineurin inhibitor before Dupixent. The revised criteria will change this step to require prior treatments with a topical corticosteroid and crisaborole (Eucrisa®) before prescribing Dupixent.
Next steps for providers: Providers should share this communication with their staff. The updated prior authorization form is under “Resource” and will be effective March 15, 2021.
Resource: Revised Dupixent Clinical Prior Authorization criteria
If you have any questions, please email TCHP Pharmacy Department at: tchppharmacy@texaschildrens.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers
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