Entyvio subcutaneous — Cigna
Ulcerative Colitis – Initial Therapy
Initial criteria
- Patient meets the standard Inflammatory Conditions – Entyvio Subcutaneous Prior Authorization Policy criteria.
- Patient has tried TWO of an adalimumab product, Skyrizi subcutaneous, an ustekinumab subcutaneous product, Zymfentra, Omvoh subcutaneous, Rinvoq, Simponi subcutaneous, Tremfya subcutaneous, Velsipity, or Xeljanz/XR OR patient has already started or is currently undergoing induction therapy with Entyvio IV.
Approval duration
6 months