Skyrizi (risankizumab-rzaa) injection — United Healthcare
moderately to severely active ulcerative colitis
Initial criteria
- Diagnosis of moderately to severely active ulcerative colitis
- Patient is not receiving Skyrizi in combination with another targeted immunomodulator [e.g., adalimumab, Entyvio (vedolizumab), Omvoh (mirikizumab-mrkz), Rinvoq (upadacitinib), Simponi (golimumab), Tremfya (guselkumab), Xeljanz/Xeljanz XR (tofacitinib), ustekinumab, Zeposia (ozanimod)]
Reauthorization criteria
- Documentation of positive clinical response to Skyrizi therapy
- Patient is not receiving Skyrizi in combination with another targeted immunomodulator [e.g., adalimumab, Entyvio (vedolizumab), Omvoh (mirikizumab-mrkz), Rinvoq (upadacitinib), Simponi (golimumab), Tremfya (guselkumab), Xeljanz/Xeljanz XR (tofacitinib), ustekinumab, Zeposia (ozanimod)]
Approval duration
12 months