Taltz (ixekizumab subcutaneous injection – Eli Lilly) — Cigna

Initial criteria

• Patient age ≥ 6 years
• Patient has tried at least one traditional systemic agent for psoriasis for ≥ 3 months unless intolerant (examples: methotrexate, cyclosporine, or acitretin) OR has a contraindication to methotrexate as determined by the prescriber
• Medication is prescribed by or in consultation with a dermatologist

Reauthorization criteria

• Patient has been established on therapy for at least 3 months
• Patient experienced a beneficial clinical response, defined as improvement from baseline in at least one of the following: estimated body surface area, erythema, induration/thickness, and/or scale of areas affected by psoriasis
• Compared with baseline, patient experienced an improvement in at least one symptom such as decreased pain, itching, and/or burning

Approval duration

initial 3 months; reauth 1 year