Cosentyx — Medical Mutual
Ankylosing Spondylitis
Initial criteria
- Prescribed by or in consultation with a rheumatologist
Reauthorization criteria
- Patient has been established on therapy for at least 6 months AND
- Patient experienced a beneficial clinical response from baseline by objective measure OR improvement in at least one symptom (pain, stiffness, function, or activities of daily living)
Approval duration
initial 6 months; reauth 1 year