Skyrizi (risankizumab)
Billing
Code: J2327
Description: Inj risankizumab-rzaa 1 mg
Unit: 1 mg
Payment: $15.519
Pay quarter: Q3 2023
Dosage and Frequency
Plaque Psoriasis
Psoriatic Arthritis
• 150 mg SQ at week 0 and 4, then every 12 weeks
Psoriatic Arthritis
• 150 mg SQ at week 0 and 4, then every 12 weeks
Crohn’s Disease
Loading dose:
• 600 mg IV at weeks 0, 4, and 8
Maintenance:
• 180 mg or 360 mg SQ at week 12, then every 8 weeks
Loading dose:
• 600 mg IV at weeks 0, 4, and 8
Maintenance:
• 180 mg or 360 mg SQ at week 12, then every 8 weeks
Calculate drug reimbursement
Total Reimbursement:
$2,467.52(ASP: $2,327.85, Margin: $139.67)
Code:
J2327# Units to bill:
150Prior Authorization
Prior auth criteria for Skyrizi may include but is not limited to:
1. Skyrizi should only be prescribed for the treatment of moderate to severe plaque psoriasis in adults who are 18 years of age and older.
2. Skyrizi should not be prescribed for anyone who has a history of anaphylaxis or other serious allergic reactions following administration of Skyrizi.
3. Patients should have failed to respond, be intolerant to, or have contraindications to other systemic therapies including cyclosporine, methotrexate, or phototherapy.
4. Before Skyrizi is prescribed, patients should be tested for tuberculosis and other opportunistic infections.
5. The prescriber must provide sufficient documentation to the payer showing that all the above criteria have been met before approval can be granted.
6. Approval is valid for 12 months and may be renewed with a new prior authorization request if appropriate.
Insurance prior auth guidelines:
Billable NDCs
00074-5015-01
Skyrizi (AbbVie Inc.)
600 MG
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