Ustekinumab (Stelara®)

Covers ustekinumab (Stelara) only for FDA‑approved indications—moderate‑to‑severe plaque psoriasis (age ≥6), adult psoriatic arthritis, adult Crohn’s disease, and adult ulcerative colitis—and excludes non‑FDA uses. Approval requires indication‑specific prior therapy trials or allowed exceptions, specialty prescriber/consultation, documentation of weight/dosing and an IV induction dose within 2 months for CD/UC, specified initial (psoriasis 3 months; others 6 months) and reauthorization durations (12 months), and documented objective or symptomatic improvement for renewal.

"Ulcerative Colitis: Individual must be 18 years of age or older."

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