Cosentyx SC (secukinumab) — Highmark

Reauthorization criteria

• Member has demonstrated disease stability or a beneficial response to therapy
• AND one of the following: (a) For AS: therapeutic failure or intolerance to at least two step 1 or 2a plan-preferred agents for AS (trial of Cimzia, an infliximab product, or Simponi also counts); (b) For PsA <18 years: therapeutic failure or intolerance to Enbrel or Stelara SC (trial of another TNFi counts toward Enbrel trial); (c) For PsA ≥18 years: therapeutic failure or intolerance to at least two step 1 or 2a plan-preferred agents for PsA (trial of Cimzia, infliximab product, or Simponi also counts toward TNFi trial); (d) For PsO: therapeutic failure or intolerance to at least two step 1 or 2a plan-preferred agents for PsO (trial of Cimzia or infliximab product counts toward TNFi trial); (e) For nr-axSpA: therapeutic failure or intolerance to at least two step 1 or 2a plan-preferred agents for nr-axSpA (trial of Enbrel, adalimumab, infliximab product, or Simponi also counts)