CommercialPrior AuthMedium impact
Topical Rosacea Products (Revised)
Humana·Dermatology, Pharmacy·Commercial
Effective date
Feb 28, 2024
We identified it
Jun 25, 2026
Summary
Humana has revised its Topical Rosacea Products pharmacy coverage policy effective February 28, 2024, implementing a step-therapy requirement for 11 topical rosacea medications. The policy now requires members to have documented previous treatment with topical metronidazole before coverage approval for alternative agents like Soolantra, Rhofade, Mirvaso, Finacea, and others.
Action Required
By February 28, 2024: Billing and prior authorization teams must implement step-therapy protocol verification for all topical rosacea product requests. Before processing approvals for MetroGel, MetroCream, Metrolotion, Noritate, Rhofade, Mirvaso, Soolantra, Finacea, ivermectin topical cream, brimonidine topical gel, or Epsolay, verify and document member's prior treatment history with topical metronidazole (0.75% cream/gel formulations). Update pharmacy benefit management system rules to flag requests lacking this documentation for denial or additional clinical review. Notify providers and patients that coverage for step-therapy alternatives requires proof of prior metronidazole therapy; claims submitted without this documentation will be denied. Pharmacy staff should screen all new rosacea medication requests against member treatment history before submission.