Spevigo (spesolimab-sbzo subcutaneous injection) — Cigna

Initial criteria

• Patient age ≥ 12 years
• Patient weight ≥ 40 kilograms
• Patient has history of at least two generalized pustular psoriasis flares of moderate-to-severe intensity in the past
• Patient has a Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) total score of 0 or 1
• Patient meets ONE of the following (a or b): a) Patient meets BOTH of the following ([1] and [2]): [1] Patient has had a 4-month trial of at least one treatment for generalized pustular psoriasis (e.g., methotrexate, acitretin, cyclosporine, or biologics); AND [2] Patient has had a history of flaring while on treatment or with dose reduction or discontinuation of treatment; OR b) Patient has tried at least one treatment for generalized pustular psoriasis but was unable to tolerate a 4-month trial
• Medication is prescribed by or in consultation with a dermatologist

Reauthorization criteria

• Patient has been established on therapy for at least 6 months
• Patient has experienced a beneficial clinical response, defined as improvement from baseline (prior to initiating the requested drug) in at least one of the following: reduction of generalized pustular psoriasis flares OR an improvement in Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) score

Approval duration

initial 6 months, reauth 1 year