Ustekinumab (Stelara®)

Stelara (ustekinumab) is covered only for FDA‑approved uses—moderate‑to‑severe plaque psoriasis (≥6 years), adult psoriatic arthritis, and adult moderately‑to‑severe Crohn’s disease and ulcerative colitis (non‑FDA uses excluded). Coverage requires indication‑specific prior therapy trials or documented intolerance/contraindication, prescriber specialty or consultation (dermatologist for psoriasis, gastroenterologist for IBD, rheumatologist/dermatologist for PsA), IV induction within 2 months and weight‑based dosing for IBD, age/weight and documentation of diagnosis, initial authorization for 3 months with 12‑month reauthorization contingent on documented response.

"Stelara is indicated for the treatment of patients 6 years or older with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy."

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