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InfliximabBlue Cross Blue Shield of Oklahoma

moderately to severely active rheumatoid arthritis (RA)

Preferred products

  • Avsola
  • Inflectra
  • Remicade
  • Ixifi
  • Renflexis
  • Infliximab (unbranded)

Initial criteria

  • Requested agent is eligible for continuation of therapy AND prescriber states patient has been treated with the requested agent within past 90 days and is at risk if therapy is changed OR
  • Diagnosis of moderately to severely active RA AND BOTH of the following:
  • - Patient has tried and had an inadequate response to maximally tolerated therapy (details continued in later section)