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The Policy VaultThe Policy Vault

Zoryve 0.3% Cream — Cigna

plaque psoriasis

Preferred products

  • Topical Corticosteroids (medium-, medium-high, high-, and/or super-high potency prescription topical corticosteroid)
  • calcipotriene 0.005% cream (Dovonex, generic)
  • calcipotriene 0.005% foam
  • calcipotriene 0.005% ointment
  • calcipotriene 0.005% solution
  • calcitriol 3 mcg/g ointment (Vectical, generic)
  • Sorilux
  • calcipotriene 0.005% and betamethasone dipropionate 0.064% ointment (Taclonex, generic)
  • calcipotriene 0.005% and betamethasone dipropionate 0.064% suspension (Taclonex, generic)
  • Enstilar
  • Wynzora

Initial criteria

  • Patient meets BOTH of the following (A and B):
  • A) Patient is age ≥ 6 years; AND
  • B) Patient meets ONE of the following (i, ii, or iii):
  • i. Patient has tried one Step 1a Product and one Step 1b Product; OR
  • ii. Patient has tried one Step 1c Product; OR
  • iii. Patient is treating plaque psoriasis affecting one of the following areas: face, eyes/eyelids, skin folds, and/or genitalia and has tried one Step 1b Product.

Approval duration

1 year