Steqeyma SC — Medical Mutual
Plaque Psoriasis
Preferred products
- Stelara SC
- Selarsdi SC
- ustekinumab-ttwe SC
- Yesintek SC
Initial criteria
- Patient has tried ≥1 oral therapy for psoriasis (e.g., methotrexate, cyclosporine, acitretin, PUVA) for ≥3 months OR
- Patient has tried ONE biologic DMARD for ≥3 months OR
- Patient has a contraindication to ≥1 oral agent for psoriasis; AND
- Patient age ≥ 6 years; AND
- Medication prescribed by or in consultation with a dermatologist
Reauthorization criteria
- Patient has received ustekinumab SC for ≥3 months; AND
- Patient experienced improvement from baseline in ≥1 of: body surface area, erythema, induration/thickness, or scale; AND
- Patient experienced symptom improvement (e.g., decreased pain, itching, burning)
Approval duration
initial 3 months, reauth 1 year