Physicians need to be aware of the danger of topical steroids. Only mild steroids should be applied to the face. The use of the topical steroid should be limited to the condition. Alternate week therapy or 3 consecutive days a week therapy is better than continuous therapy in preventing steroid-induced rosacea. Only the mildest topical steroid should be used on the face if a condition warrants such use. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) does not necessary prevent steroid induced rosacea. Similar conditions have been seen with both Elidel and Protopic, possibly from immunosuppression and Demodex or bacterial growth.
This program divides certain therapeutic categories of drugs into two or more levels called Tiers. Tier 1 medications are preferred as the first step for treating a member’s health condition. They are cost effective and are usually available without PA. Members that do not achieve a clinical success with Tier 1 medications may qualify to obtain a Tier 2 or Tier 3 medication. Most of these categories are set up so that if a member meets the step therapy criteria, their claim for the next highest tier will process without a PA. Alternately, a PA may be required so that OHCA will have documentation of the step therapy and/or other clinical information necessary to approve the use of a Tier 2 or higher medication. Providers who have members with clinical exceptions may request a PA to skip the step therapy process and receive the Tier 2 or Tier 3 drug immediately. Please see each therapeutic category for specific clinical criteria required to bypass the step therapy protocol.
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