Sotyktu — Medical Mutual

Plaque Psoriasis

Initial criteria

Patient is age ≥ 18 years; AND
Patient meets ONE of the following (a or b):
a) Patient has tried at least one traditional systemic agent for psoriasis for at least 3 months, unless intolerant; OR
Note: Examples include methotrexate, cyclosporine, or acitretin tablets; a 3‑month trial of PUVA also counts.
Exception: A 3‑month trial or previous intolerance to at least one biologic other than the requested drug meets requirement.
b) Patient has a contraindication to methotrexate, as determined by the prescriber; AND
The medication is prescribed by or in consultation with a dermatologist.

Patient has been established on therapy for at least 3 months; AND
Patient experienced a beneficial clinical response, defined as improvement from baseline in at least one of the following: estimated body surface area, erythema, induration/thickness, and/or scale of areas affected by psoriasis; AND
Compared with baseline, patient experienced an improvement in at least one symptom, such as decreased pain, itching, and/or burning.

initial 3 months; reauth 1 year