Baricitinib (Olumiant) for Severe Alopecia Areata Treatment Recommendations

CADTH recommends that Olumiant be reimbursed by public drug plans for adults with severe alopecia areata (AA) under specific conditions. It should be covered for those with at least 50% scalp hair loss, with the AA episode lasting more than 6 months but less than 8 years. Prescription should be by a dermatologist experienced in severe AA, and the cost should be reduced. Olumiant should not be combined with other JAK inhibitors, biologic immunomodulators, or systemic immunosuppressants. Initial reimbursement is for 36 weeks, with potential extensions every 12 months if improvements continue.