Tremfya (guselkumab) — United Healthcare
Moderately to severely active Crohn’s disease
Initial criteria
- Diagnosis of moderately to severely active Crohn’s disease
- Patient is not receiving Tremfya in combination with another targeted immunomodulator [e.g., adalimumab, Cimzia (certolizumab), Entyvio (vedolizumab), Omvoh (mirikizumab-mrkz), Rinvoq (upadacitinib), Skyrizi (risankizumab), ustekinumab]
Reauthorization criteria
- Documentation of positive clinical response to Tremfya therapy
- Patient is not receiving Tremfya in combination with another targeted immunomodulator [e.g., adalimumab, Cimzia (certolizumab), Entyvio (vedolizumab), Omvoh (mirikizumab-mrkz), Rinvoq (upadacitinib), Skyrizi (risankizumab), ustekinumab]
Approval duration
12 months