Rinvoq extended-release tablets — Cigna

Initial criteria

• Patient age ≥ 18 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

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 such as decreased 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