abatacept — CareFirst (Caremark)
active psoriatic arthritis (PsA)
Initial criteria
- Member age ≥2 years
- Authorization of 12 months may be granted if previously received a biologic or targeted synthetic drug indicated for active PsA OR one of:
- — Mild to moderate disease with inadequate response to methotrexate, leflunomide, or another csDMARD (e.g., sulfasalazine) at adequate dose and duration
- — Intolerance or contraindication to methotrexate, leflunomide, or sulfasalazine
- — Presence of enthesitis
- — Severe disease
Reauthorization criteria
- Authorization of 12 months may be granted for members with positive clinical response
Approval duration
12 months