Stelara (ustekinumab)

Stelara (ustekinumab) is covered only for its FDA‑approved indications — moderate‑to‑severe plaque psoriasis (age ≥6), adult psoriatic arthritis, and adult moderately‑to‑severely active Crohn’s disease and ulcerative colitis — and not for non‑FDA indications. Coverage requires indication‑specific criteria including specialist prescribing/consultation, age limits, documentation of prior trials of specified systemic agents (or corticosteroid trial/contraindication/other alternatives for IBD), a single IV induction dose within 2 months before SC maintenance for IBD, weight-based dosing documentation, and proof of clinical improvement for reauthorization (≥90 days for psoriasis; ≥6 months for other indications).

"Stelara is indicated for the treatment of adult patients with active psoriatic arthritis (PsA)."

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