Stelara® (ustekinumab)

Stelara (ustekinumab) is covered only for FDA‑approved indications (moderate–severe plaque psoriasis and psoriatic arthritis for ages ≥6; Crohn’s disease and ulcerative colitis for adults ≥18); off‑label uses are excluded. Coverage requires documentation of age/diagnosis, specialty prescriber/consultation, required IV induction within 2 months for CD/UC, prior trial or intolerance/contraindication to specified systemic agents (or disease‑specific criteria such as fistula/resection for CD), weight‑based dosing, and minimum treatment durations with objective or symptomatic benefit for reauthorization (≥90 days for psoriasis; ≥6 months for CD/UC/PsA).

"Stelara is indicated for the treatment of patients 6 years or older with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy."

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