Limited Coverage Drugs – ustekinumab for psoriatic arthritis

Last updated on September 17, 2024

 

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Generic name: ustekinumab

Brand name

Strength

Form

Jamteki™

45 mg/0.5 mL pre-filled syringe
90 mg/1 mL
Wezlana™ 45 mg/0.5 mL pre-filled syringe
single-use vial
90 mg/1 mL pre-filled syringe
Steqeyma® 45 mg/0.5 mL pre-filled syringe
90 mg/1 mL pre-filled syringe

Special Authority criteria

Approval period

For the treatment of adult patients with active psoriatic arthritis (PsA) according to established criteria1 when 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