Spevigo (spesolimab‑sbzo) subcutaneous prior authorization
Defines prior authorization and medical necessity criteria for subcutaneous Spevigo for prevention of generalized pustular psoriasis (GPP) flares for Colorado Rocky Mountain Health Plans members; applies to prescribers (dermatologists) and pharmacy/medical benefit adjudication.
Added coverage criteria for self- or caregiver-administered subcutaneous loading dose.
Revised diagnostic criteria per consensus guidelines and updated combination use language.
Program established as a Prior Authorization/Medical Necessity policy for Spevigo subcutaneous formulations with P&T approvals in 5/2024, 5/2025, 10/2025.
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