Orencia (abatacept subcutaneous injection) — Cigna

Initial criteria

• Patient is age ≥ 18 years
• Patient has tried ONE conventional synthetic DMARD for at least 3 months (e.g., methotrexate, leflunomide, hydroxychloroquine, sulfasalazine) OR has already had a 3‑month trial of at least one biologic other than the requested drug
• 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 when assessed by at least one objective measure OR improvement in at least one symptom (e.g., decreased joint pain, morning stiffness, fatigue, improved function, or decreased soft tissue swelling)

Approval duration

initial 6 months; reauth 1 year