Otrexup (methotrexate) — CareFirst (Caremark)

Preferred products

• generic oral methotrexate
• generic injectable methotrexate

Initial criteria

• Member has had an inadequate response or intolerance to generic oral methotrexate
• Member has an inability to prepare and administer generic injectable methotrexate

Reauthorization criteria

• Member continues to meet initial coverage criteria
• Member has achieved or maintained a positive clinical response after at least 3 months of therapy with Otrexup as evidenced by low disease activity or improvement in signs and symptoms of the condition

Approval duration

12 months