Cosentyx — Medical Mutual

Initial criteria

• Patient age ≥ 18 years
• Patient has tried at least one other therapy such as corticosteroids, systemic antibiotics, or isotretinoin
• Prescribed by or in consultation with a dermatologist

Reauthorization criteria

• Patient has been established on therapy for at least 90 days
• Patient experienced beneficial clinical response from baseline by objective measure (Hurley staging, Sartorius score, Physician Global Assessment, Hidradenitis Suppurativa Severity Index)
• Patient experienced improvement in at least one symptom such as decreased pain, drainage of lesions, nodules, or cysts

Approval duration

initial 3 months; reauth 1 year