Taltz (ixekizumab) — United Healthcare
Psoriatic Arthritis
Preferred products
- adalimumab (preferred products)
- Cimzia (certolizumab)
- Cosentyx (secukinumab)
- Enbrel (etanercept)
- Simponi (golimumab)
- Skyrizi (risankizumab)
- ustekinumab (preferred products)
- Tremfya (guselkumab)
Initial criteria
- Diagnosis of active psoriatic arthritis
- History of failure to a 3 month trial of methotrexate at maximally indicated dose unless contraindicated or adverse effects (document date/duration)
- OR previously treated with targeted immunomodulator FDA-approved for psoriatic arthritis (document drug/date/duration; e.g., Cimzia, Cosentyx, adalimumab, Simponi, ustekinumab, Tremfya, Xeljanz, Otezla, Skyrizi, Rinvoq, Enbrel)
- History of failure, contraindication, or intolerance to three preferred products: one preferred adalimumab product, Cimzia, Cosentyx, Enbrel, Simponi, Skyrizi, one preferred ustekinumab product, or Tremfya
- History of failure, contraindication, or intolerance to one of: Orencia, Xeljanz/Xeljanz XR, or Rinvoq
- Patient is not receiving Taltz in combination with another targeted immunomodulator [e.g., Enbrel, Cimzia, Simponi, Orencia, adalimumab, ustekinumab, Skyrizi, Tremfya, Cosentyx, Xeljanz, Olumiant, Rinvoq, Otezla]
- Prescribed by or in consultation with a rheumatologist or dermatologist
Approval duration
12 months