Product Details

Stelara

Ustekinumab
90 mg/mL
Solution for Injection
Single-Use Prefilled Syringe Pack

DIN/PIN/NPN

02320681

Manufacturer

Janssen Inc.

Formulary Listing Date

2013-10-31  

Unit Price

4593.1400

Amount MOH Pays

4593.1400

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

L04AC05

Interchangeable Products

NO  

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
680 12 months from date of authorization

For 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.
681 12 months from date of authorization

For 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.
 

EAP Criteria

NO

Product Monograph

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