Cosentyx — Cigna

Initial criteria

• Patient meets the standard Inflammatory Conditions – Cosentyx Subcutaneous Prior Authorization Policy criteria
• Patient is currently receiving Cosentyx (subcutaneous or intravenous)
• Patient has tried TWO of Enbrel, an adalimumab product, Rinvoq, Taltz, or Xeljanz/XR for Ankylosing Spondylitis; OR TWO of Cimzia, Taltz, or Rinvoq for nr-axSpA; OR TWO of Enbrel, an adalimumab product, Otezla, Skyrizi subcutaneous, Sotyktu, an ustekinumab subcutaneous product, Taltz, or Tremfya subcutaneous for Plaque Psoriasis; OR for Psoriatic Arthritis: if age ≥ 18 years, TWO of Enbrel, an adalimumab product, Otezla, Rinvoq/Rinvoq LQ, Skyrizi subcutaneous, an ustekinumab subcutaneous product, Taltz, Tremfya subcutaneous, or Xeljanz/XR; if age < 18 years, ONE of Enbrel, Otezla, Rinvoq/Rinvoq LQ, or an ustekinumab subcutaneous product [documentation required]

Approval duration

1 year