Icotyde

Generic: icotrokinra HCl

200 Mg — Tablet

Also known as: Icotyde 200 Mg Tablet

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 1 hour, 20 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026	Tier 4 - Specialty	✓	—	✓ Specialty Pharmacy Required	PA \| QL

1 plan

Source: Excel (XLSX) · Formulary date: May 29, 2026 · Checked: 1 hour, 18 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via icotrokinra HCl	Tier 3 - Non-Formulary	—	—	—	None