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Taltz (ixekizumab)Point32Health

Plaque Psoriasis

Initial criteria

  • Documented diagnosis of plaque psoriasis
  • Patient age ≥ 6 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, vitamin D analog, tazarotene, calcineurin inhibitors, anthralin, coal tar OR contraindication to all of the following topical therapies: corticosteroids, vitamin D analogs, tazarotene, calcineurin inhibitors, anthralin, coal tar OR previous treatment with a biologic agent indicated for the requested use OR patient is new to the plan and stable on the requested agent prior to enrollment