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DrugOtezla® (apremilast) [Celgene Corporation]

September 2019

Therapeutic area - Auto-inflammatory diseases

Approval criteria

  • Patient is at least 18 years of age AND
  • Patient has oral ulcers associated with Behçet’s Disease AND
  • Otezla is prescribed by a dermatologist AND
  • Patient has tried colchicine at maximum tolerated dose for at least 3 months, unless contraindicated


  • Refer to the PA criteria, “Immunomodulators,” if patient has one of the following diagnoses:
    • Psoriatic arthritis OR
    • Plaque psoriasis

Quantity limit

Quantity limits are based on creatinine clearance calculated by the Cockcroft-Gault equation and must be provided at time of request

  • CrCl ≥ 30 mL per minute: 60 mg/day
  • CrCl < 30 mL per minute: 30 mg/day


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

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