Limited Use Note(s)

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USTEKINUMAB90mg/mL Inj Sol-Pref Syr Pk
Reason For Use CodeClinical Criteria
680For the treatment of severe plaque psoriasis in patients who meet the following criteria: - Patients who become pregnant during the transition period of July 31, 2024, to January 31, 2025.
LU Authorization Period: 12 months from date of authorization.
681For the treatment of severe plaque psoriasis in patients who meet the following criteria: - Patients who require palliative care during the transition period of July 31, 2024, to January 31, 2025.
LU Authorization Period: 12 months from date of authorization.