Omvoh® (Mirikizumab-Mrkz) – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers Omvoh (mirikizumab‑mrkz) given as the three FDA‑labeled IV induction doses for adults with moderately to severely active ulcerative colitis or Crohn’s disease, excludes concomitant use with other targeted immunomodulators, and generally treats self‑administered subcutaneous Omvoh under the pharmacy benefit unless the member’s plan or a California delegated review specifies otherwise. Medical necessity requires documentation of diagnosis and FDA‑label dosing, prior inadequate response/failure to specified conventional therapies or prior treatment with an FDA‑approved targeted immunomodulator (as applicable), prescription by or consultation with a gastroenterologist, and authorization is limited to the three induction doses.

"Prior authorization and member-specific benefit plan terms may supersede or change coverage (see Benefit Considerations and Instructions for Use)."