HHSC requires prior authorization for Emflaza (deflazacort). Deflazacort is FDA-approved for the treatment of Duchenne muscular dystrophy (DMD) in clients 2 years and older. Prescribing providers complete and submit the Emflaza Standard Prior Authorization Addendum (HHS Form 1347).
Treatment approval criteria for Emflaza include the following:
- Clients 2 years and older with a diagnosis DMD.
- The client has tried prednisone for three months or longer and has one the following adverse events as a result prednisone use:
- Cushingoid appearance;
- Central (truncal) obesity;
- Undesirable weight gain (greater than or equal to 10% body weight gain over a six-month period);
- Diabetes and/or hypertension that is difficult to manage; or
- Experienced a severe behavioral adverse event.
For renewal requests, prescribing providers should complete sections 1, 5 and 6 of the form.
Reasons for denial include but are not limited to the following:
- Less than 2 years old
- Use of CYP3A4 in last 90 days
- No previous trial with prednisone