Tysabri® (Natalizumab) – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers natalizumab (Tysabri) as monotherapy for relapsing forms of multiple sclerosis and for induction/maintenance of response/remission in moderately to severely active Crohn’s disease (after inadequate response/intolerance to conventional therapies and TNF‑inhibitors) and excludes its use in combination with other DMTs, B‑cell therapies, lymphocyte‑trafficking blockers, and (for CD) concomitant immunosuppressants or TNF‑inhibitors, and considers it unproven for other conditions/MS types. Coverage requires FDA‑label dosing, enrollment in the TOUCH Prescribing Program with certified providers, documentation of diagnosis/prior therapy failures (for CD) and positive clinical response for continuation, anti‑JCV/PML risk monitoring, and authorizations limited to ≤12 months.

"Relapsing forms of multiple sclerosis (MS) — Tysabri (natalizumab) is medically necessary for the treatment of relapsing forms of multiple sclerosis (e."