Spevigo (spesolimab-sbzo) — Point32Health

Initial criteria

• Documented diagnosis of generalized pustular psoriasis
• Documentation of one (1) of the following: a) At least two (2) generalized pustular psoriasis flares OR b) The condition has persisted for more than three months
• Patient is age ≥ 12 years AND weighs ≥ 40 kg
• Prescribed by a dermatologist

Reauthorization criteria

• Documented diagnosis of generalized pustular psoriasis
• Documentation of one (1) of the following: a) At least two (2) generalized pustular psoriasis flares OR b) The condition has persisted for more than three months
• Patient is age ≥ 12 years AND weighs ≥ 40 kg
• Prescribed by a dermatologist
• Documentation the patient has experienced a therapeutic response as defined by a decrease in GPP flares

Approval duration

initial 6 months; reauth 12 months