Bryhali

Drugs - Bryhali™ (halobetasol propionate lotion) [Valeant Pharmaceuticals North America LLC]

August 2019

Therapeutic area - Steroids, Topical

Initial approval criteria

Patient age ≥ 18 years of age AND
Be prescribed by a dermatologist AND
Patient has a diagnosis of moderate to severe plaque psoriasis AND
Failed to adequately respond to at least one other high potency topical corticosteroid (e.g., betamethasone, clobetasol, fluocinonide, etc.) AND
Failed to adequately respond to at least one oral treatment (cyclosporine, methotrexate)
Patient does not have a history of allergic contact dermatitis with halobetasol propionate AND
Halobetasol propionate lotion will be administered topically; it is not intended to be used orally, ophthalmically, or intravaginally or on the face, groin, or axillae AND
Initial approval is for 2 fills (28-day supply per fill)

Patient continues to be carefully monitored for adverse effects by a healthcare provider throughout the duration of treatment as documented in patient chart notes AND
Patient has demonstrated clinical improvement in response to treatment as documented in patient chart notes
Renewal approval is for 2 fills (28-day supply per fill)

MHCP Provider Call Center 651-431-2700 or 800-366-5411