CurrentAnthemPolicy N/A

Topical corticosteroid preferred products and prescribing guidance

Guidance for Anthem providers on prescribing preferred topical corticosteroid products to avoid pharmacy claim rejections; affects prescribing and pharmacy benefit verification for Anthem members.

Policy Summary

PayerAnthem

PolicyTopical corticosteroid preferred products and prescribing guidance

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionVerify coverage by reviewing the Anthem Preferred Drug List (PDL) on the Anthem provider website prior to prescribing.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

multiplepreferred topical corticosteroid agents listed by potency

quarterlyPDL update frequency

800-450-8753Provider Services phone for questions

Prescribing and Pharmacy Verification Actions

Prior Authorization

Prior authorization / step therapy may apply

Prior authorization and step therapy may apply to select preferred topical corticosteroid products; prescribers should check the Anthem Preferred Drug List (PDL) for specific utilization management requirements before prescribing.

Step Therapy

Step therapy advisory

Step therapy may apply to select preferred topical corticosteroids. Specific step rules and any required trials are specified on the Anthem Preferred Drug List (PDL).

Note

Coverage verification — check the PDL

Verify coverage by reviewing the Anthem Preferred Drug List (PDL) on the Anthem provider website prior to prescribing to confirm product preference and any associated requirements.

Policy Summary

PayerAnthem

PolicyTopical corticosteroid preferred products and prescribing guidance

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionVerify coverage by reviewing the Anthem Preferred Drug List (PDL) on the Anthem provider website prior to prescribing.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Denial Risk

Risk of claim rejection for nonpreferred products

Pharmacy claim rejections may occur for nonpreferred topical corticosteroid products; prescribing nonpreferred products can trigger prior authorization, step therapy, or pharmacy claim denials at the point of sale.

To avoid delays, consider prescribing preferred products listed on the PDL.
The PDL is subject to change quarterly; verify current status before prescribing.

Clinical Background

Topical corticosteroids are grouped by potency — commonly described as low, medium, high, and very high potency — and are used to treat inflammatory dermatologic conditions. Selection of an appropriate potency depends on the severity of the condition, the treatment site, and patient factors; lower potencies are typically used for mild inflammation and on thin or sensitive skin, while higher and very high potency agents are reserved for more severe or recalcitrant dermatoses or thicker skin areas.

This guidance is intended to help prescribers choose preferred topical corticosteroid products to avoid pharmacy claim rejections and reduce delays in therapy. Anthem’s Hot Tip emphasizes that prescribing preferred agents when appropriate can prevent additional steps at the pharmacy; additionally, some preferred products may be subject to prior authorization or step therapy, and coverage should be verified on the Anthem Preferred Drug List (PDL), which is updated quarterly.

Key Definitions

Preferred Drug List (PDL)

DefinitionPreferred Drug List (PDL) — Anthem's formulary listing that identifies preferred prescription products and any utilization management requirements.

Action for prescribersPrescribe preferred products when possible to avoid pharmacy claim rejections and delays at the pharmacy.

Utilization managementPrior authorization and step therapy may apply to select preferred products; check the PDL for specific requirements.

Coverage verificationVerify coverage by reviewing the Preferred Drug List (PDL) on the Anthem provider website before prescribing.

PDL updatesThe PDL is subject to change quarterly.