Enbrel (etanercept) — United Healthcare

Plaque Psoriasis

Initial criteria

Diagnosis of chronic moderate to severe plaque psoriasis
AND
Patient is not receiving Enbrel in combination with another targeted immunomodulator [e.g., Cimzia (certolizumab), Simponi (golimumab), Orencia (abatacept), adalimumab, Stelara (ustekinumab), Skyrizi (risankizumab), Tremfya (guselkumab), Cosentyx (secukinumab), Taltz (ixekizumab), Siliq (brodalumab), Ilumya (tildrakizumab), Xeljanz (tofacitinib), Olumiant (baricitinib), Rinvoq (upadacitinib), Otezla (apremilast)]

Documentation of positive clinical response to Enbrel therapy
AND
Patient is not receiving Enbrel in combination with another targeted immunomodulator [e.g., Cimzia (certolizumab), Simponi (golimumab), Orencia (abatacept), adalimumab, Stelara (ustekinumab), Skyrizi (risankizumab), Tremfya (guselkumab), Cosentyx (secukinumab), Taltz (ixekizumab), Siliq (brodalumab), Ilumya (tildrakizumab), Xeljanz (tofacitinib), Olumiant (baricitinib), Rinvoq (upadacitinib), Otezla (apremilast)]

12 months