Cimzia (certolizumab pegol subcutaneous injection [lyophilized powder or solution] – UCB) — Cigna

Initial criteria

• Patient is age ≥ 18 years
• Medication is prescribed by or in consultation with a rheumatologist

Reauthorization criteria

• Patient has been established on therapy for at least 6 months
• Patient experienced a beneficial clinical response from baseline when assessed by at least one objective measure (e.g., ASDAS, ASQoL, BASDAI, BASFI, BAS-G, BASMI, DFI, HAQ-S, or serum markers such as C-reactive protein or erythrocyte sedimentation rate) OR patient experienced an improvement in at least one symptom compared with baseline (e.g., decreased pain or stiffness, improved function or activities of daily living)

Approval duration

initial 6 months, reauth 1 year