Kineret — Cigna
Rheumatoid Arthritis – initial therapy
Preferred products
- Actemra subcutaneous
- Tyenne subcutaneous
- Enbrel
- adalimumab-adbm
- Cyltezo
- adalimumab-adaz
- adalimumab-ryvk
- Simlandi
- Rinvoq
- Xeljanz tablets
- Xeljanz XR
Initial criteria
- Patient meets the standard Inflammatory Conditions – Kineret Prior Authorization Policy criteria; AND
- Patient has tried TWO of a tocilizumab subcutaneous product, Enbrel, an adalimumab product, Rinvoq, or Xeljanz/XR [documentation required]; OR
- Patient has been established on Kineret at least 90 days and prescription claims history indicates at least a 90-day supply of Kineret was dispensed within the past 130 days [verification in prescription claims history required], or if claims history is not available, according to the prescriber [verification by prescriber required]
Approval duration
6 months