Dupixent® (dupilumab)

Covered only for FDA‑approved indications (atopic dermatitis, asthma, CRSwNP, eosinophilic esophagitis, prurigo nodularis, and COPD); non‑FDA uses are excluded. Key requirements include indication‑specific age/diagnostic criteria, documentation of baseline tests (e.g., blood eosinophils — ≥150 cells/µL for asthma, ≥300 cells/µL for COPD — biopsies/endoscopy/CT where applicable), trials of specified prior therapies, prescriber specialty (allergist/immunologist/dermatologist/pulmonologist/ENT), and reauthorization after typically 6 months (4 months for atopic dermatitis) with documented clinical benefit.

"Atopic dermatitis: treatment of adult and pediatric patients aged 6 months and older with moderate to severe atopic dermatitis whose disease is not adequately controlled with topical prescription t..."

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