Halcinonide (Halog) (PDF)
Defines medical necessity, prior authorization and utilization limits for Halcinonide (Halog) cream and ointment for dermatologic inflammation and pruritus within Centene-affiliated health plans (HIM line of business). Includes initial and continued therapy criteria, dose limits, exclusions, therapeutic alternatives, contraindications, product availability and administrative notes.
Added step therapy bypass for IL HIM per IL HB 5395 and revised redirection to generic halcinonide cream for brand Halog cream requests for IL HIM.
Added redirection to generic halcinonide cream for brand Halog requests and noted prior authorization may be required for generic halcinonide cream.
Removed 30 g ointment tube formulation as it is no longer commercially available.
References reviewed and updated in multiple annual reviews (2021-2025); no significant clinical changes for most reviews.