Adalimumab Products — Cigna
Uveitis (including other posterior uveitides and panuveitis syndromes)
Initial criteria
- Patient is age ≥ 2 years
- Patient has tried one of the following therapies: periocular, intraocular, or systemic corticosteroids OR immunosuppressives OR a biologic other than the requested medication
- Medication is prescribed by or in consultation with an ophthalmologist
Reauthorization criteria
- Patient has been established on therapy for at least 6 months
- Patient experienced a beneficial clinical response when assessed by at least one objective measure OR patient experienced improvement in at least one symptom (e.g., decreased eye pain, redness, light sensitivity, blurred vision, or improved visual acuity)
Approval duration
initial 6 months, reauth 1 year