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

Interstitial Lung Disease Associated with Systemic Sclerosis (SSc-ILD)

Initial criteria

Patient age ≥ 18 years
Patient has elevated acute phase reactants defined as at least ONE of: C-reactive protein (CRP) ≥ 6 mg/mL OR erythrocyte sedimentation rate (ESR) ≥ 28 mm/h OR platelet count ≥ 330 x 10^9/L
Forced vital capacity (FVC) > 55% of predicted value
Diagnosis confirmed by high-resolution computed tomography
Medication prescribed by or in consultation with a pulmonologist or a rheumatologist

Patient age ≥ 18 years
Patient has experienced a beneficial response to therapy over the previous 1 year while receiving a tocilizumab product (for patients with < 1 year of therapy, response from baseline prior to initiating therapy). Examples include reduction in anticipated decline in forced vital capacity, improvement in 6-minute walk distance, or reduction in number or severity of disease-related exacerbations
Medication prescribed by or in consultation with a pulmonologist or a rheumatologist

1 year