Skip to content
The Policy VaultThe Policy Vault

Zeposia (ozanimod)Medica

Relapsing forms of multiple sclerosis (including clinically isolated syndrome, relapsing remitting disease, and active secondary progressive disease)

Initial criteria

  • Patient has a relapsing form of multiple sclerosis; AND
  • Medication is prescribed by or in consultation with a neurologist or a physician who specializes in the treatment of multiple sclerosis

Reauthorization criteria

  • Patient has a relapsing form of multiple sclerosis; AND
  • Patient experienced a beneficial clinical response when assessed by at least one objective measure (e.g., stabilization or reduced worsening in disease activity as evaluated by MRI, EDSS, NEDA-3/NEDA-4, FSIQ-RMS, relapse rate, mobility measures, MSFC, or brain volume loss); OR
  • Patient experienced stabilization, slowed progression, or improvement in at least one symptom (e.g., motor function, fatigue, vision, bowel/bladder function, spasticity, walking/gait, or pain/numbness/tingling); AND
  • Medication is prescribed by or in consultation with a neurologist or a physician who specializes in the treatment of multiple sclerosis

Approval duration

1 year