anakinra — CareFirst (Caremark)
Adult-onset Still’s disease (AOSD)
Initial criteria
- Member has active systemic features such as fever, arthralgia/arthritis, evanescent rash, lymphadenopathy, hepatomegaly, splenomegaly, sore throat
- Member has had inadequate response to at least one of the following: nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or a conventional synthetic drug (e.g., methotrexate)
Reauthorization criteria
- Documentation supporting positive clinical response
Approval duration
12 months