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The Policy VaultThe Policy Vault

KevzaraMedica

ulcerative colitis

Preferred products

  • adalimumab products (Cyltezo, adalimumab-adbm, adalimumab-adaz, Simlandi/adalimumab-ryvk)
  • Enbrel
  • Cosentyx SC
  • Otezla
  • Skyrizi SC
  • Sotyktu
  • Stelara SC
  • Taltz
  • Tremfya SC
  • Omvoh SC
  • Zymfentra
  • Velsipity

Initial criteria

  • Patient meets the respective standard Prior Authorization Policy criteria for the condition
  • Trial and failure, contraindication, or intolerance to TWO Step 1 or Step 2a Preferred Products appropriate for the indication [documentation required]
  • Non-Preferred Product request must be directed to indicated Step 1 therapy (e.g., adalimumab) when specified in table

Reauthorization criteria

  • Patient is continuing therapy with a Non-Preferred Product and verification of prior use for 90 to 120 days within a 130-day look-back period is confirmed via claims or prescriber verification
  • Continuation otherwise meets standard Prior Authorization Policy criteria

Approval duration

1 year