Spevigo® (Spesolimab-Sbzo) – IV and Subcutaneous Formulations (for UHCWest Only) – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers Spevigo IV for treatment of confirmed generalized pustular psoriasis (GPP) flares and Spevigo SC for prevention/maintenance of GPP only when strict diagnostic and severity criteria are met (GPPPGA subscores/BSA/new/worsening pustules, labs as applicable), with IV limited to a maximum of two doses per flare (authorization ≤21 days) and SC initial/continuation use limited to documented prior flares or prior IV use with authorization ≤12 months; dosing must follow FDA labeling, be prescribed by a dermatologist, and not be used concomitantly with other targeted immunomodulators. Spevigo is excluded/not medically necessary for non‑GPP indications (atopic dermatitis, Crohn’s disease, hidradenitis suppurativa, palmoplantar pustulosis, plaque psoriasis, ulcerative colitis) and requires documentation (GPPPGA scores, clinical notes, labs) to support coverage.

"Prescriber attestation that the patient has experienced flares of a severity and/or frequency such that they would clinically benefit from prophylactic therapy with subcutaneous Spevigo."