Cosentyx subcutaneous — Medica
Ankylosing Spondylitis
Preferred products
- adalimumab-adbm
- adalimumab-adaz
- adalimumab-ryvk
- Simlandi
- Enbrel
- Rinvoq
- Taltz
- Xeljanz tablets
- Xeljanz XR
Initial criteria
- Patient meets the standard Inflammatory Conditions – Cosentyx Subcutaneous Prior Authorization Policy criteria
- Patient has tried TWO of Enbrel, an adalimumab product, Rinvoq, Taltz, and Xeljanz/XR (Cimzia, infliximab products, or Simponi also count)
Approval duration
6 months