Cimzia — Cigna

Initial criteria

• Patient age > 2 years
• Patient meets ONE of the following: a) has tried one other systemic medication for JIA; OR b) will be starting therapy concurrently with methotrexate, sulfasalazine, or leflunomide; OR c) has an absolute contraindication to methotrexate, sulfasalazine, or leflunomide; OR d) has aggressive disease as determined by the prescriber
• Medication is prescribed by or in consultation with a rheumatologist

Reauthorization criteria

• Patient has been established on therapy for at least 6 months
• Patient meets ONE of the following: a) experienced beneficial clinical response by at least one objective measure; OR b) experienced improvement in at least one symptom (e.g., limitation of motion, joint pain, stiffness, fatigue, function or activities of daily living)

Approval duration

initial 6 months, renewal 1 year