Western Health Advantage - All plan years
Cosentyx Sensoready Pen (secukinumab)
Drugs for the Skin : Drugs for the Skin
  • HoFH:
    Duration: 1 year(s)
    Required Medical Information: History of untreated/pretreated LDL
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Reauthorization Required: No
    Duration of Reauthorization: N/A
    Diagnosis verbiage includes presence of cutaneous or tendon xanthomas before age 10: No
    Diagnosis verbiage includes evidence of HeFH in both parents: No
    Baseline LDL-C Level to Initiate Therapy (% reduction): N/A
    Baseline LDL-C Level to Initiate Therapy (mgdL): Unspecified
    Concomitant therapy required with Bile acid sequestrant or niacin: No
    Concomitant therapy required with ezetimibe: No
    Concomitant therapy required with maximally tolerated statin: No
    Documentation Period of LDL-C Levels: N/A
    LDL-C Level for Reauthorization (mgdL): N/A
    LDL-C Level for Reauthorization (% reduction): N/A
    Lifestyle modifications required: No
    PushTronex MUST be used after Syringe or Sureclick: No

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  • ST_APPLIES
  • ST_APPLIES