Rinvoq extended-release tablets — Cigna

Initial criteria

• Patient age ≥ 2 years
• Patient has had a 3‑month trial of at least one tumor necrosis factor inhibitor OR was unable to tolerate a 3‑month trial of a tumor necrosis factor inhibitor
• Medication is prescribed by or in consultation with a rheumatologist or a dermatologist

Reauthorization criteria

• Patient has been established on therapy for at least 6 months
• Patient experienced a beneficial clinical response from baseline when assessed by at least one objective measure OR compared with baseline experienced improvement in at least one symptom such as less joint pain, morning stiffness, or fatigue; improved function or activities of daily living; decreased soft tissue swelling in joints or tendon sheaths

Approval duration

initial 6 months, reauth 1 year