Limited Coverage Drugs – ustekinumab for psoriatic arthritis

Last updated on May 30, 2024

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Generic name: ustekinumab
Brand name	Strength	Form
Jamteki™	45 mg/0.5 mL	pre-filled syringe
	90 mg/1.0 mL	pre-filled syringe

Special Authority criteria	Approval period
For the treatment of adult patients with active psoriatic arthritis (PsA) according to established criteria¹when prescribed by a rheumatologist	First approval: 1 year Renewal: 1 year

Practitioner exemptions

None

Special notes

¹Established criteria are explained in the Special Authority forms below
PharmaCare coverage will not be provided for ustekinumab in combination with other biologic drugs or a janus kinase (JAK)-inhibitor for the treatment of PsA
PharmaCare covers a maximum 84-day supply per fill of ustekinumab

Special Authority requests

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Limited Coverage Drugs – ustekinumab for psoriatic arthritis

Generic name: ustekinumab

Brand name

Strength

Form

Special Authority criteria

Approval period

Practitioner exemptions

Special notes

Special Authority requests