Actemra (tocilizumab subcutaneous injection - Genentech/Roche) — Cigna

Initial criteria

• Patient age > 18 years
• Patient has tried or is currently taking a systemic corticosteroid OR systemic corticosteroids are contraindicated
• Medication is prescribed by or in consultation with a rheumatologist

Reauthorization criteria

• Patient is currently receiving a tocilizumab subcutaneous or intravenous product AND has been established on therapy for at least 6 months
• Patient meets at least ONE of the following: when assessed by at least one objective measure, experienced a beneficial clinical response from baseline OR improvement in at least one symptom (e.g., decreased headache, scalp or jaw pain, decreased fatigue, improved vision)

Approval duration

initial 6 months; reauth 1 year