Rinvoq extended-release tablets — Cigna

Initial criteria

• Patient is age > 18 years
• Patient has tried or is currently taking a systemic corticosteroid, or systemic corticosteroids are contraindicated
• The medication is prescribed by or in consultation with a rheumatologist

Reauthorization criteria

• Patient has been established on therapy for at least 6 months
• Patient meets ONE of the following: (a) When assessed by at least one objective measure, patient experienced a beneficial clinical response from baseline; OR (b) Compared with baseline, patient experienced an improvement in at least one symptom such as decreased headache, scalp or jaw pain, decreased fatigue, and/or improved vision

Approval duration

initial: 6 months; reauth: 1 year