MedicaidPrior AuthMedium impact
Prior Authorization of Dupixent (dupilumab) – Pharmacy Services MAB 01-19-16
Pennsylvania Medicaid (DHS)·PA · Dermatology, Allergy & Immunology, Pulmonology·Prior Authorization
Effective date
Jul 8, 2019
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid now requires prior authorization for all Dupixent (dupilumab) prescriptions effective July 8, 2019. Prescriptions must meet specific clinical criteria including specialist consultation and documented failure of other treatments for atopic dermatitis or asthma.
Action Required
Effective July 8, 2019: Providers must obtain prior authorization for all Dupixent (dupilumab) prescriptions for Pennsylvania Medicaid patients. Ensure prescriptions are written by or in consultation with appropriate specialists (dermatologist, immunologist, allergist, pulmonologist). Document therapeutic failure of required treatments per policy guidelines. Use Section I procedures in the Prior Authorization of Pharmaceutical Services Handbook for requests.