Taltz (ixekizumab) — United Healthcare
active ankylosing spondylitis
Initial criteria
- Diagnosis of active ankylosing spondylitis or active non-radiographic axial spondyloarthritis
- AND
- Patient is not receiving Taltz in combination with another targeted immunomodulator [e.g., Enbrel (etanercept), Cimzia (certolizumab), Simponi (golimumab), Orencia (abatacept), adalimumab, Xeljanz (tofacitinib), Olumiant (baricitinib), Rinvoq (upadacitinib)]
Reauthorization criteria
- Documentation of positive clinical response to Taltz therapy
- AND
- Patient is not receiving Taltz in combination with another targeted immunomodulator [e.g., Enbrel (etanercept), Cimzia (certolizumab), Simponi (golimumab), Orencia (abatacept), adalimumab, Xeljanz (tofacitinib), Olumiant (baricitinib), Rinvoq (upadacitinib)]
Approval duration
12 months