Skyrizi (risankizumab-rzaa) — Point32Health
Crohn’s Disease
Initial criteria
- Documented diagnosis of Crohn’s disease
- Patient age ≥ 18 years
- Prescribed by or in consultation with a gastroenterologist
- Documentation of one (1) of the following: a) Inadequate response or adverse reaction to at least two of the following: Corticosteroids, 5-aminosalycylates, 6-mercaptopurine, or methotrexate; b) Contraindication to corticosteroids, 5-aminosalycylates, 6-mercaptopurine, and methotrexate; c) The patient is moderate to high risk as evidenced by deep ulcers on colonoscopy, long segments of small and/or large bowel involvement, perianal disease, extra-intestinal manifestations (e.g., fever, weight loss, abdominal pain, intermittent nausea/vomiting), history of bowel resections, or recent hospitalization for the disease; d) Previous treatment with a biologic agent indicated for the requested use; e) The patient is new to the plan and has been stable on the requested agent prior to enrollment