Minocycline ER (Emrosi, Solodyn, Ximino, Minolira), Microspheres (Arestin), Foam (Zilxi)
Defines medical necessity criteria, prior authorization requirements, age limits, step-therapy and dosing/approval durations for minocycline extended-release products (acne), minocycline microspheres (Arestin) for periodontitis, and minocycline foam/capsule products (Zilxi, Emrosi) for rosacea across Centene lines of business (Commercial, HIM, Medicaid) with specific exclusions for Arestin on pharmacy benefit.
Clarified that Arestin is excluded for Commercial line of business on the pharmacy benefit.
Added Emrosi to criteria with corresponding criteria set for rosacea indication.
Added step therapy bypass for Illinois HIM per IL HB 5395.
Revised requirement for IR minocycline for acne vulgaris to 'must use' language.
Revised approval duration for Commercial line of business to 12 months or duration of request, whichever is less.
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.