Rinvoq — CareFirst (Caremark)

Initial criteria

• Adult member with active ankylosing spondylitis or active non-radiographic axial spondyloarthritis
• Member has experienced an inadequate response or intolerance to at least one TNF inhibitor OR has previously received a biologic (other than a TNF inhibitor) or targeted synthetic drug (e.g., Xeljanz) indicated for active AS or nr-axSpA

Reauthorization criteria

• Adult member using the medication for AS or nr-axSpA and achieves or maintains positive clinical response

Approval duration

12 months