Vitamin D Analogs Topical ST With Limit Post PA Policy 1381 E Udr 07 2023 1
Defines initial step therapy with quantity limits and post-step-therapy prior authorization criteria for topical Vitamin D analog products (multiple brands/formulations) for treatment of psoriasis under CVS Caremark criteria as used by Neighborhood Health Plan of Rhode Island.
No material clinical/coverage changes — policy remains the same (has_material_change=false).
Coverage Summary
This policy covers topical Vitamin D analogs (calcipotriene and calcitriol formulations, including combination products with betamethasone such as Enstilar, Taclonex, and Wynzora) with step therapy and product-specific quantity limits; products listed in the policy will be paid without prior authorization only when the initial step therapy criteria and the initial quantity limits are met, otherwise a prior authorization is required. (Scope: topical Vitamin D analogs for psoriasis; Coverage stance: covered_with_criteria.)
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