Kevzara (sarilumab subcutaneous injection – Regeneron/SanofiAventis) — Cigna

Initial criteria

• Patient weight ≥ 63 kg
• Patient has tried one other systemic therapy for this condition OR will start Kevzara concurrently with methotrexate, sulfasalazine, or leflunomide OR has an absolute contraindication to these agents OR 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 experienced a beneficial clinical response from baseline assessed by at least one objective measure OR improvement in at least one symptom

Approval duration

initial 6 months; reauth 1 year