Cosentyx® (Secukinumab) – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers IV Cosentyx (secukinumab) administered by a healthcare professional for adults with active psoriatic arthritis, ankylosing spondylitis, or non‑radiographic axial spondyloarthritis (IV use is not medically necessary for plaque psoriasis, enthesitis‑related arthritis, or hidradenitis suppurativa), while self‑administered subcutaneous Cosentyx is covered under the pharmacy benefit. Coverage requires FDA‑labeled dosing, prescriber specialty (rheumatologist/dermatologist for PsA; rheumatologist for AS/nr‑axSpA), documentation of prior therapy (3 months of methotrexate for PsA or two NSAIDs ≥4 weeks each for AS/nr‑axSpA unless contraindicated, or prior targeted immunomodulator), justification that IV route is necessary with attestation the patient/caregiver cannot self‑administer, no concomitant targeted immunomodulators, documentation of positive response for renewals, and 12‑month authorization limits.

"Authorization durations are limited to 12 months for initial and renewal requests (continuation) as specified."