Ponvory (ponesimod tablets − Vanda) — Cigna

Relapsing forms of multiple sclerosis (clinically isolated syndrome, relapsing remitting disease, active secondary progressive disease) in adults

Initial criteria

Patient has a relapsing form of multiple sclerosis; AND
Medication is prescribed by or in consultation with a neurologist or a physician who specializes in the treatment of multiple sclerosis

Patient has a relapsing form of multiple sclerosis; AND
Patient meets ONE of the following (a or b):
a) Patient experienced a beneficial clinical response when assessed by at least one objective measure; OR
b) Patient experienced stabilization, slowed progression, or improvement in at least one symptom such as motor function, fatigue, vision, bowel/bladder function, spasticity, walking/gait, or pain/numbness/tingling sensation; AND
Medication is prescribed by or in consultation with a neurologist or a physician who specializes in the treatment of multiple sclerosis

1 year