Adalimumab Products — Cigna

Initial criteria

• Patient is age > 18 years
• Patient has tried one systemic corticosteroid OR one other immunosuppressant for at least 2 months or was intolerant
• Medication is prescribed by or in consultation with a dermatologist

Reauthorization criteria

• Patient has been established on therapy for at least 4 months
• Patient experienced beneficial clinical response defined as improvement in size, depth, or number of lesions
• Patient experienced improvement in at least one symptom such as decreased pain or tenderness of affected lesions

Approval duration

initial 4 months, reauth 1 year