Crisaborole (Eucrisa)


Indications for Prior Authorization:

  • Treatment of mild to moderate atopic dermatitis in patients 2 years of age and older

Patients must meet the following criteria for the indication(s) above:

  • Prescribed by or in collaboration with a dermatologist, AND
  • Chart note documentation required documenting diagnosis of mild-to-moderate atopic dermatitis, drugs tried and failed and reason for failure, AND
  • Patient is 2 years of age or older, AND
  • Exacerbating factor that could contribute to the member's atopic dermatitis have been evaluated and addressed (e.g., non-compliance with therapy, environmental triggers, allergy patch testing, etc.); AND
  • Patient has tried and failed a 2-week trial or two generic medicum to high potency corticosteroids unless contraindicated (e.g., areas involving the face, neck or intertriginous areas), AND
  • Patient has tried and failed Elidel


  • Apply topially to affected areas twice daily


  • 3 months

The site you are transferring to is not hosted by WHA. WHA's Terms of Use and internet Privacy Practices do not apply to your use of this linked site. Please review the policies on privacy and terms of use for the linked site. WHA does not control the accuracy, completeness, or timeliness of the content on the linked site.

Press Esc to cancel

El sitio Web al que está siendo transferido no es provisto por WHA. Las Condiciones de Uso y las Prácticas de Privacidad en Internet de WHA no se aplican a este sitio Web asociado que usted está usando. Revise las políticas sobre la privacidad y condiciones de uso de este sitio Web asociado. WHA no tiene control sobre la exactitud, la totalidad o la actualidad del contenido del sitio Web asociado. WHA no puede garantizar que los servicios de traducción de idiomas estarán disponibles en el sitio vinculado.

Presione «Esc» para cancelar