Kevzara (sarilumab) — CareFirst (Caremark)

Initial criteria

• Adult member with PMR
• Any of the following:
• Inadequate response to systemic corticosteroids
• Disease flare during corticosteroid taper
• Inadequate response to methotrexate
• Intolerance or contraindication to both systemic corticosteroids and methotrexate

Reauthorization criteria

• Positive clinical response as evidenced by low disease activity or improvement in signs/symptoms when there is improvement in any of the following: morning stiffness, hip/shoulder pain, hip/shoulder range of motion, CRP and/or ESR

Approval duration

12 months