Skip to content
The Policy VaultThe Policy Vault

Zeposia (ozanimod)Highmark

Ulcerative Colitis

Initial criteria

  • age ≥ 18 years
  • diagnosis of ulcerative colitis classified as moderately to severely active
  • prescribed by or in consultation with a gastroenterologist
  • experienced therapeutic failure or intolerance to at least two step 1 plan-preferred agents for the treatment of ulcerative colitis

Reauthorization criteria

  • member has demonstrated disease stability or a beneficial response to therapy

Approval duration

12 months