WHA
 

Eohilia (budesonide)

Indications for Prior Authorization

Eohilia (budesonide)
  • For diagnosis of Eosinophilic Esophagitis (EoE)
    Indicated for 12 weeks of treatment in adult and pediatric patients 11 years of age and older with eosinophilic esophagitis (EoE). Limitations of Use EOHILIA has not been shown to be safe and effective for the treatment of EoE for longer than 12 weeks.

Criteria

Eohilia

Prior Authorization

Length of Approval: 12 Weeks [A]
For diagnosis of Eosinophilic Esophagitis (EoE)

  • Diagnosis of eosinophilic esophagitis (EoE)
    • AND
  • Provider attests to both of the following:
    • Patient is experiencing a new occurrence of EoE [B]
      • AND
    • Medication will not be used for longer than 12 weeks for any one occurrence of EoE
    AND
  • Patient has symptoms of esophageal dysfunction (e.g., dysphagia, food impaction, heartburn, abdominal pain)
    • AND
  • Patient has at least 15 intraepithelial eosinophils per high power field (HPF)
    • AND
  • Other causes of esophageal eosinophilia have been excluded
    • AND
  • Patient is 11 years of age or older
    • AND
  • Trial and failure (of a minimum 8-week duration), contraindication, or intolerance to a proton pump inhibitor (e.g., pantoprazole, omeprazole)
    • AND
  • Trial and failure (of a minimum 8-week duration), or intolerance to a topical (esophageal) corticosteroid (e.g., budesonide, fluticasone)
    • AND
  • Prescribed by or in consultation with one of the following:
    • Allergist/Immunologist
    • Gastroenterologist

  • Guideline ID
    GL-506303

  • Formulary
    Premium

  • Effective date
    Apr 1, 2026

  • P&T approval date
    Apr 17, 2024

P & T Revisions

2026-01-26, 2025-12-18, 2025-04-02, 2024-04-16

  1. Eohilia Prescribing Information. Takeda Pharmaceuticals America Inc. Lexington, MA 02421. January 2025.
  2. Study Details | A Study in Adolescents and Adults With Eosinophilic Esophagitis (EoE) Measuring Histologic Response and Determine if Reduction in Dysphagia is Achieved | ClinicalTrials.gov https://clinicaltrials.gov/study/NCT02605837. Accessed 8 March, 2024.
  3. Gonsalves NP, Aceves SS. Diagnosis and treatment of eosinophilic esophagitis. J Allergy Clin Immunol. 2020;145(1):1-7.
  4. Hirano I, Chan ES, Rank MA, et al. AGA Institute and the Joint Task Force on allergy-immunology practice parameters clinical guidelines for the management of eosinophilic esophagitis. Gastroenterology. 2020;158:1776-86.
  5. Dellon ES, Khoury P, Muir AB, et al. A clinical severity index for eosinophilic esophagitis: development, consensus, and future directions. Gastroenterology. 2022;1-18.
  6. MD consult April 2024 with gastroenterologist
  7. Nonevski, I. and Myburgh, S. Eosinophilic esophagitis for the advanced practice provider. Available at: https://www.igiejournal.org/article/S2949-7086(23)00104-8/pdf. Accessed January 22, 2026.
  8. Bortoli, N., Visaggi, P., Penagini, R., et al. The 1st EoETALY Consensus on the Diagnosis and Management of Eosinophilic Esophagitis–Current Treatment and Monitoring. Available at: https://www.sciencedirect.com/science/article/pii/S1590865824003013#:~:text=%2D-,Endoscopy%20with%20esophageal%20biopsies%20is%20currently%20the%20gold%20standard%20for,well%20with%20the%20histologic%20activity. Accessed January 22, 2026.
  9. Dellon, E., Muir, A., Katzka, D., et al. ACG Clinical Guideline: Diagnosis and Management of Eosinophilic Esophagitis. Available at: https://journals.lww.com/ajg/fulltext/2025/01000/acg_clinical_guideline__diagnosis_and_management.16.aspx. Accessed January 22, 2026.
  10. Greuter T, Bussmann C, Safroneeva E, Schoepfer AM, Biedermann L, Vavricka SR, Straumann A. Long-term treatment of eosinophilic esophagitis with swallowed topical corticosteroids: development and evaluation of a therapeutic concept. Am J Gastroenterol 2017;112:1527-35.
  1. EOHILIA has not been shown to be safe and effective for the treatment of EoE for longer than 12 weeks (1)
  2. Eosinophilic esophagitis (EoE) is a chronic condition. The main goals of treatment are to achieve histologic remission, reduce/eliminate symptoms, and improve quality of life. Treatment response is assessed by clinical, endoscopic, and histologic disease activity. EoE recurrence is common after discontinuation of drug treatment. In the clinical studies (Study 1 and Study 2) of Eohilia, only 53% (Study 1) and 38% (Study 2) achieved histological remission (peak esophageal intraepithelial eosinophil count ≤6 eos/hpf). The general consensus in clinical literature for EoE treatment, recommends to continue maintenance therapy to prevent relapse of EoE. A study in Switzerland found that the average duration of therapy can be as long as 2 years. Regularly following-up with symptomatic, endoscopic and histologic assessment is recommended to prevent disease progression. [1, 6-10]
  • 2026-01-26: Update guideline
  • 2025-12-18: no criteria changes, added IL statute operational note
  • 2025-04-02: 2025 Annual Review. No criteria changes. Background updates.
  • 2024-04-16: New program for Eohilia.