Tremfya® Intravenous (guselkumab)

Tremfya (guselkumab) IV is covered only as induction therapy for adults (≥18) with moderately‑to‑severely active Crohn’s disease or ulcerative colitis (not for maintenance), and mesalamine products do not count as prior systemic therapy. Approval (3 months) requires documentation of age and diagnosis, gastroenterologist prescribing/consultation, prior trial and failure/intolerance/contraindication of one systemic agent (e.g., adalimumab, infliximab, ustekinumab, risankizumab, azathioprine, 6‑mercaptopurine, methotrexate) or disease‑specific alternatives (Crohn’s: systemic steroid trial/contraindication, enterocutaneous/rectovaginal fistulas, or ileocolonic resection; UC: pouchitis with prior antibiotic/probiotic/corticosteroid‑ or mesalamine‑enema), with recommended induction dosing 200 mg IV at weeks 0, 4, and 8.

"Crohn's Disease: Has enterocutaneous (perianal or abdominal) or rectovaginal fistulas"