Entyvio Pen — Point32Health

Initial criteria

• Documented diagnosis of ulcerative colitis
• Patient age ≥ 18 years
• Prescribed by or in consultation with a gastroenterologist
• Documentation of one (1) of the following: (c) Trial and failure of at least two of the listed medications from each of the following therapeutic categories (only one medication is required if only one is available for a listed therapeutic category): Interleukin Antagonists (Omvoh, Skyrizi, Tremfya, Yesintek), Janus Kinase Inhibitors (Rinvoq, Xeljanz), Sphingosine 1‑phosphate receptor modulator (Zeposia), Tumor Necrosis Factors (Humira, Simponi) OR (d) Contraindication to all of the following medications: Omvoh, Skyrizi, Tremfya, Yesintek, Rinvoq, Xeljanz, Zeposia, Humira, and Simponi