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Spesolimab-sbzo (Spevigo®)
BCBS Tennessee·TN · Dermatology·Medical Policy
Effective date
Jul 31, 2026
We identified it
Jun 17, 2026
Summary
New medical policy establishes prior authorization requirements for Spesolimab-sbzo (Spevigo®) for treating generalized pustular psoriasis in patients 12+ years old. Must be prescribed by dermatologist with specific clinical documentation and TB screening required.
Action Required
Before July 31, 2026: Billing team must implement prior authorization requirements for Spesolimab-sbzo (Spevigo®). Update system to require dermatologist prescription, clinical documentation of GPP diagnosis with genetic testing or biopsy results, TB screening within 12 months, and severity assessments. Create workflow for 1-month authorization for active flares vs 12-month authorization for maintenance therapy. Train staff on required documentation differences between flare and non-flare scenarios.