Zymfentra (infliximab-dyyb) SC — Highmark

Initial criteria

• age ≥ 18 years
• diagnosis of ulcerative colitis classified as moderately to severely active
• one of the following: already received at least three doses of infliximab IV at least 6 weeks before initiating Zymfentra or currently undergoing induction therapy with infliximab IV; OR experienced therapeutic failure or intolerance to at least two step 1 or 2a 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