Vedolizumab (Entyvio)

Vedolizumab (Entyvio) is covered for adults (≥18) with FDA‑approved moderately to severely active ulcerative colitis or Crohn’s disease and is excluded for off‑label use, concurrent biologic therapy, active severe infection, or patients <18. Coverage requires documentation of diagnosis and disease severity, prior inadequate response/loss of response or intolerance to a TNF inhibitor or an immunomodulator (or corticosteroid dependence/intolerance), adherence to the IV dosing schedule (300 mg at 0, 2, 6 weeks then every 8 weeks), evidence of therapeutic benefit by week 14 for reauthorization, and approvals are granted for 12 months.

"For re-authorization: clinical evidence of therapeutic benefit by week 14 of therapy (e."

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