adalimumab-adaz — CareFirst (Caremark)

Initial criteria

• Moderately to severely active Crohn’s disease

Reauthorization criteria

• Member (including new members) with moderately to severely active Crohn’s disease who achieves or maintains remission OR shows positive clinical response evidenced by low disease activity or improvement in signs and symptoms with improvement in any of: abdominal pain or tenderness, diarrhea, body weight, abdominal mass, hematocrit, mucosal appearance on endoscopy/CTE/MRE/ultrasound, improvement on disease activity scoring tool (e.g., CDAI score)

Approval duration

12 months