adalimumab (preferred products) — Highmark
Plaque Psoriasis (PsO)
Initial criteria
- age ≥ 18 years
- diagnosis of moderate to severe PsO
- prescribed by or in consultation with a dermatologist or rheumatologist
- EITHER experienced therapeutic failure or intolerance to phototherapy (for example, PUVA, UVB) OR experienced therapeutic failure or intolerance to at least one systemic therapy (for example, methotrexate) OR contraindicated to both phototherapy and systemic therapy
Reauthorization criteria
- member has demonstrated disease stability or a beneficial response to therapy