Skip to content
The Policy VaultThe Policy Vault

Steqeyma SCMedical Mutual

Crohn’s Disease SQ Maintenance (adults)

Preferred products

  • Stelara SC
  • Selarsdi SC
  • ustekinumab-ttwe SC
  • Yesintek SC

Initial criteria

  • Patient age > 18 years; AND
  • Patient will receive single ustekinumab IV induction dose within 2 months prior to SC initiation; AND
  • Patient meets one of: trial/using corticosteroids OR contraindicated; OR trial of one conventional systemic therapy (azathioprine, 6-MP, methotrexate); OR patient has already tried one biologic; OR has fistulas; OR had ileocolonic resection; AND
  • Medication prescribed by or in consultation with gastroenterologist

Reauthorization criteria

  • Patient established on ustekinumab SC ≥6 months; AND
  • Patient demonstrated beneficial response by objective measure (e.g., fecal markers, serum markers, imaging, endoscopy, reduced corticosteroid requirement) OR improved symptoms (e.g., pain, fatigue, stool frequency, blood in stool)

Approval duration

initial 6 months, reauth 1 year