Omvoh™ (mirikizumab-mrkz) Intravenous
EVICORE-MEDICAL_DRUG-CD1CE581
Omvoh (mirikizumab‑mrkz) IV is covered only as induction therapy for adults (≥18) with moderately to severely active ulcerative colitis — or for pouchitis meeting the alternative criteria — and is not covered for patients <18 or for maintenance/outside the specified induction regimen. Authorization requires documented diagnosis and age, prescription or consultation by a gastroenterologist, prior trial of an appropriate systemic UC agent (e.g., adalimumab, infliximab, ustekinumab, azathioprine/6‑MP, cyclosporine, tacrolimus, or a corticosteroid) or, for pouchitis, trial of an antibiotic/probiotic/corticosteroid enema/mesalamine enema, planned dosing of 300 mg IV at Weeks 0, 4, and 8 (three induction doses, ≤2 months), and meeting applicable safety criteria.
"Patient must be 18 years of age or older."
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