Sotyktu — Medica
Plaque psoriasis
Preferred products
- Enbrel
- Humira
- Amjevita
- Otezla
- Skyrizi (subcutaneous pen or syringe)
- Stelara (subcutaneous)
- Taltz
- Tremfya
Initial criteria
- Approve for 1 year if the patient meets ALL of the following (i and ii):
- i. Patient meets the standard Inflammatory Conditions – Sotyktu Prior Authorization Policy criteria; AND
- ii. Patient meets ONE of the following conditions (a or b):
- a) Patient has tried TWO of Enbrel, Humira, Amjevita, Otezla, Skyrizi subcutaneous (pen or syringe), Stelara subcutaneous, Taltz, or Tremfya [documentation required]; OR
- Note: A trial of multiple adalimumab products counts as ONE product.
- b) Patient has been established on Sotyktu for at least 90 days AND prescription claims history indicates at least a 90‑day supply of Sotyktu was dispensed within the past 130 days [verification in prescription claims history required]; if claims history is not available, according to the prescriber [verification by prescriber required].
- Note: An exception is allowed if the prescriber has verified the patient has been receiving Sotyktu for at least 90 days AND the patient has been receiving Sotyktu via paid claims (not samples or coupons).
Approval duration
1 year