Cimzia (certolizumab pegol) — Point32Health

Initial criteria

• Documented diagnosis of plaque psoriasis
• Patient is at least age ≥ 18 years
• Prescribed by or in consultation with a dermatologist
• Documentation of one (1) of the following: inadequate response to one of the following topical therapies: a corticosteroid, a vitamin D analog, tazarotene, calcineurin inhibitor, anthralin, or coal tar OR contraindication to all of the following topical therapies: corticosteroids, vitamin D analogs, tazarotene, calcineurin inhibitors, anthralin, and coal tar OR previous treatment with a biologic agent indicated for the requested use OR patient is new to the plan and has been stable on the requested agent prior to enrollment