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

Initial criteria

• Patient is age > 18 years
• Patient has tried one systemic corticosteroid
• The medication is prescribed by or in consultation with a rheumatologist

Reauthorization criteria

• Patient has been established on therapy for at least 6 months
• When assessed by at least one objective measure, patient experienced a beneficial clinical response from baseline OR compared with baseline, patient experienced an improvement in at least one symptom such as decreased shoulder, neck, upper arm, hip, or thigh pain or stiffness; improved range of motion; and/or decreased fatigue

Approval duration

initial 6 months, reauth 1 year