Mirikizumab-mrkz

Covers mirikizumab‑mrkz (Omvoh) intravenous induction (300 mg IV at Weeks 0, 4, and 8) with subcutaneous maintenance for FDA‑approved indications in adults — specifically moderately to severely active ulcerative colitis (approved 10/26/2023) and Crohn’s disease (approved 1/15/2025) — for patients with inadequate response, loss of response, or intolerance to prior therapies. Coverage is limited to adults ≥18 without active infection, is subject to the member’s benefit plan (self‑administered dosing is managed under the pharmacy benefit), off‑label uses require recognition in accepted compendia or two peer‑reviewed supporting articles, and other exclusions (pediatric use, non‑formulary indications, and indications lacking adequate evidence or long‑term data) apply.

"Coverage of an FDA‑approved drug when prescribed for a use recognized as safe and effective in one or more standard medical reference compendia adopted by the U."