etanercept products — Cigna

Initial criteria

• Patient age > 2 years; AND the medication is prescribed by or in consultation with a rheumatologist or dermatologist

Reauthorization criteria

• Patient has been established on therapy for at least 6 months; AND patient experienced a beneficial clinical response measured objectively (e.g., Disease Activity Index for Psoriatic Arthritis, CPDAI, PsA DAS, LEI, SPARCC, etc.) OR an improvement in symptoms such as joint pain, morning stiffness, fatigue, function or activities of daily living, or soft tissue swelling

Approval duration

initial 6 months, reauth 1 year