Limited coverage drugs – risankizumab

Generic name

risankizumab

Strength

pre-filled syringe: 75 mg/0.83 mL

pre-filled syringe, pre-filled pen: 150 mg/1 mL

Form

syringe (subcutaneous injection)

pen (subcutaneous injection)

 
Special Authority criteria Approval period

For the treatment of moderate to severe plaque psoriasis, according to established criteria described in Special Authority request form 5380, when prescribed by a dermatologist

First approval: 16 weeks

Renewal: 1 year

Practitioner exemptions

  • None

Special notes

  • None

Special Authority requests