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

Initial criteria

• Patient is age > 2 years
• 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 less joint pain/tenderness, stiffness, or swelling; decreased fatigue; improved function or activities of daily living

Approval duration

initial 6 months, reauth 1 year