Medicare AdvantagePrior AuthLow impact
Spevigo (spesolimab-sbzo) subcutaneous syringe (Revised)
Humana·Dermatology, Rheumatology·Medicare Advantage
Effective date
Jul 24, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Spevigo (spesolimab-sbzo) subcutaneous syringe for generalized pustular psoriasis patients who are NOT experiencing a flare. The medication must be prescribed by a dermatologist or rheumatologist with documented prior therapy failure or contraindication to oral systemic treatments.
Action Required
Immediately: For Humana Medicare Advantage patients prescribed Spevigo (spesolimab-sbzo) subcutaneous syringe, providers must obtain prior authorization before dispensing. Ensure prescribing dermatologist or rheumatologist documents: 1) diagnosis of generalized pustular psoriasis currently NOT in flare, 2) prior therapy failure/intolerance/contraindication to oral systemic treatments (acitretin, methotrexate). Failure to obtain prior auth will result in claim denials.