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
- PA_APPLIES
- ST_APPLIES
- ST_APPLIES
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