Kevzara (sarilumab) — CareFirst (Caremark)
Immune checkpoint inhibitor–related toxicity (inflammatory arthritis)
Initial criteria
- Member has moderate or severe immunotherapy-related inflammatory arthritis
- Either of the following:
- Inadequate response to corticosteroids or a conventional synthetic drug (methotrexate, sulfasalazine, leflunomide, or hydroxychloroquine)
- Intolerance or contraindication to corticosteroids and a conventional synthetic drug (methotrexate, sulfasalazine, leflunomide, or hydroxychloroquine)
Reauthorization criteria
- Positive clinical response as evidenced by low disease activity or improvement in signs and symptoms of the condition
Approval duration
12 months