HHSC will revise the clinical prior authorization criteria for Dupixent (dupilumab) on Jan. 4, 2022. The U.S. Food and Drug Administration approved Dupixent on Oct. 20, 2021, as an add-on maintenance treatment for individuals 6 years and older with moderate-to-severe eosinophilic phenotype asthma, or with oral corticosteroid dependent asthma. The expanded prior authorization criteria will allow providers to prescribe Dupixient following the expanded age indication.
HHSC does not require MCOs to implement Dupixent clinical prior authorization criteria. However, MCOs using the criteria must incorporate the above revisions by Jan. 4, 2022.