Vedolizumab (Entyvio®)

Vedolizumab (Entyvio) is covered for adults (≥18) with moderately to severely active Crohn’s disease or ulcerative colitis for FDA‑approved indications and is not covered for pediatric patients or non–FDA‑approved uses. Coverage requires specified prior‑therapy trials per indication (Crohn’s: trial of a biologic OR one conventional systemic therapy OR systemic corticosteroids OR documented contraindication to steroids; UC: trial of one systemic or biologic), prescription by or consultation with a gastroenterologist, adherence to the 300 mg IV dosing schedule (0, 2, 6 weeks, then every 8 weeks), initial authorization for 14 weeks, and 12‑month renewals with documented therapeutic response and applicable safety documentation.

"Entyvio is an integrin receptor antagonist indicated for the treatment of Crohn's Disease and Ulcerative colitis in adults with moderately to severely active disease."