Enbrel (etanercept) — Point32Health
Plaque Psoriasis
Initial criteria
- Documented diagnosis of plaque psoriasis
- Patient is age ≥ 4 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: corticosteroids, vitamin D analogs, tazarotene, calcineurin inhibitors, anthralin, 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 the patient is new to the plan and has been stable on the requested agent prior to enrollment