Tremfya (guselkumab subcutaneous injection) — Cigna

Initial criteria

• Patient age ≥ 18 years; AND
• Patient meets ONE of the following conditions: a) Tried at least one traditional systemic agent for psoriasis (e.g., methotrexate, cyclosporine, or acitretin) for ≥ 3 months, unless intolerant; OR b) Contraindication to methotrexate; AND
• Medication prescribed by or in consultation with a dermatologist

Reauthorization criteria

• Patient has been established on therapy for at least 3 months; AND
• Patient experienced a beneficial clinical response defined as improvement from baseline in at least one of: body surface area, erythema, induration/thickness, and/or scale; AND
• Improvement in at least one symptom such as decreased pain, itching, and/or burning

Approval duration

initial 3 months, reauth 1 year