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Dupixent Clinical Prior Authorization Criteria Revision Effective March 15, 2021

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On March 15, 2021, the Texas Vendor Drug Program will revise the Dupixent clinical prior authorization. 

Dupixent is Federal Drug Administration (FDA)-approved for multiple indications, including the treatment of atopic dermatitis. The current criteria require a trial with a topical corticosteroid and a topical calcineurin inhibitor before Dupixent. Step 3 of the revised criteria will change this step to require prior treatments with a topical corticosteroid and crisaborole (Eucrisa®) before prescribing Dupixent. This update will better align the clinical prior authorization criteria with the Preferred Drug List criteria.

This clinical prior authorization is optional for Medicaid managed care organizations (MCOs). The Pharmacy Clinical Prior Authorization Assistance Chart shows the prior authorization each MCO uses and how those authorizations relate to the authorizations used for processing fee-for-service Medicaid claims. This chart is updated quarterly. Providers can also refer to the MCO Resources for links to each MCO's list of clinical prior authorizations.

Email questions or comments to vdp-formulary@hhsc.state.tx.us.