Vedolizumab (Entyvio®)
EVICORE-MEDICAL_DRUG-ACA53B99
Vedolizumab (Entyvio) is covered only for adults (≥18) with FDA‑approved moderately to severely active Crohn’s disease or ulcerative colitis and is not supported for other indications. Initial authorization (14 weeks) requires prescription by or consultation with a gastroenterologist and disease‑specific prior‑therapy documentation (for Crohn’s: enterocutaneous/rectovaginal fistula, prior ileocolonic resection, prior biologic or conventional systemic therapy, prior/current systemic corticosteroids, or steroid contraindication; for UC: trial of one systemic or biologic agent), and reauthorization (12 months) requires documented therapeutic response (recommended dosing 300 mg IV at 0, 2, and 6 weeks, then every 8 weeks).
"Entyvio is an integrin receptor antagonist indicated for the treatment of Crohn's Disease and Ulcerative colitis in adults with moderately to severely active disease."