Health Net
Siliq (brodalumab)
Drugs for the Skin : Drugs for the Skin
  • Prior Authorization: Psoriasis (PsO):
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Step Therapy: Psoriasis (PsO):
    ST Multiple Brands

  • Psoriasis (PsO):
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): 1 of Dermatologist;Rheumatologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 6 month(s)
    TB Test required: No
    History of Plaque Psoriasis: N/A
    Overall % of Body Surface For Initiation: 3
    Overall % of Body Surface For Initiation With Sensitive Areas: Unspecified
    Psoriasis Classification: Unspecified
    Sensitive Area BSA Percent override: Yes

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