Cosentyx (secukinumab subcutaneous injection – Novartis) — Cigna

Initial criteria

• Patient is age ≥ 18 years
• Patient has objective signs of inflammation defined as at least ONE of the following: (a) C-reactive protein elevated beyond the upper limit of normal; OR (b) Sacroiliitis reported on magnetic resonance imaging
• Medication is prescribed by or in consultation with a rheumatologist

Reauthorization criteria

• Patient has been established on Cosentyx subcutaneous or intravenous for at least 6 months
• Patient meets at least ONE of the following: (a) Objective measure shows beneficial clinical response from baseline; OR (b) Improvement in ≥ 1 symptom such as decreased pain or stiffness or improved function or activities of daily living

Approval duration

6 months initial, 1 year reauth