Cosentyx — Medical Mutual

Initial criteria

• Patient has objective signs of inflammation defined as elevated C-reactive protein OR sacroiliitis on MRI
• Prescribed by or in consultation with a rheumatologist

Reauthorization criteria

• Patient has been established on therapy for at least 6 months AND
• Patient experienced 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