Siliq — Cigna
Plaque Psoriasis
Preferred products
- Enbrel
- adalimumab-adbm
- Cyltezo
- adalimumab-adaz
- adalimumab-ryvk
- Simlandi
- Otezla
- Skyrizi subcutaneous (pen or syringe)
- Sotyktu
- Stelara subcutaneous
- Imuldosa subcutaneous
- Selarsdi subcutaneous
- ustekinumab-ttwe subcutaneous
- Yesintek subcutaneous
- Taltz
- Tremfya subcutaneous
Initial criteria
- Patient meets the standard Inflammatory Conditions – Siliq Prior Authorization Policy criteria for plaque psoriasis
- Patient has tried TWO of Enbrel, an adalimumab product, Otezla, Skyrizi subcutaneous, Sotyktu, an ustekinumab subcutaneous product, Taltz, or Tremfya subcutaneous [documentation required]
Reauthorization criteria
- Patient meets the standard Inflammatory Conditions – Siliq Prior Authorization Policy criteria
- Patient has tried TWO of Enbrel, an adalimumab product, Otezla, Skyrizi subcutaneous, Sotyktu, an ustekinumab subcutaneous product, Taltz, or Tremfya subcutaneous [documentation required] OR patient has been established on Siliq for at least 90 days with verified paid prescription claims
Approval duration
initial 3 months; reauth 1 year