Tildrakizumab-Asmn (Ilumya)
EVICORE-MEDICAL_DRUG-9FD99F25
Ilumya (tildrakizumab‑asmn) is covered only for adults (≥18) with FDA‑approved moderate‑to‑severe plaque psoriasis who are candidates for systemic therapy or phototherapy; pediatric and off‑label uses are excluded. Initial approval requires a 3‑month trial or intolerance to at least one biologic or traditional systemic agent (or a contraindication to methotrexate), prescriber/consultation by a dermatologist, label dosing (100 mg SC at weeks 0 and 4 then no more frequently than every 12 weeks), with initial authorization for 3 months and renewals up to 12 months contingent on documented clinical response.
"Ilumya is indicated for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy."
Sign up to see full coverage criteria, indications, and limitations.